The precursors’s adaptation to pregnancy, prenatal attachment and maternal self-confidence

We investigated the precursors for prenatal attachment (PA), adaptation to pregnancy and maternal self-confidence, and the relationship of these variables with each other. This cross-sectional study was conducted between July and December 2020. Data were obtained using an online survey from social media groups. The mean Prenatal Self Evaluation Questionnaire scores of women had a negative and moderate correlation with mean Pharis Self-Confidence Scale (r=–0.287, p=.000) and negative and weak correlation with mean Prenatal Attachment Inventory scores (r=–0.317, p=.000). Women who conceived following assisted reproductive techniques had a higher level of readiness to give birth (17.62 ± 5.22) than women who conceived spontaneously (29.57 ± 6.15) (β=–0.285, t=–3.547, p=.002). We concluded that when women’s adaptation to pregnancy increased in the prenatal period, their PA level and self-confidence towards baby care increased. The results of this study may guide healthcare professionals in terms of improving care for women who have attachment and adaptation problems during pregnancy. Women who conceived following assisted reproductive techniques can be reassured that infertility does not have a negative impact on their readiness for birth. Healthcare professionals could ensure adaptation in women who have problems with adaptation during pregnancy by initiating interventions that support PA and increase the maternal self-confidence levels of women.Impact Statement What is already known on this subject? There were few studies examining the relationship between women’s conception style with prenatal attachment (PA), adaptation to pregnancy, and maternal self-efficacy. What do the results of this study add? In this study, it was determined that women who conceived following assisted reproductive techniques have higher levels of being ready to give birth than women who conceived spontaneously without medical assistance. Additionally, it was found that as women evaluate themselves positively in the prenatal period, their PA and maternal self-confidence level regarding baby care increased. What are the implications of these findings for clinical practice and/or further research? Since this study examines the precursors of maternal self-confidence, PA and adaptation to pregnancy in Turkish pregnant women, it was shown that studies in different cultures are needed in terms of generalisability of the results. In addition, there is a need to identify risky women who have low self-confidence in baby care during pregnancy and have attachment and adjustment problems, and to culture-specific intervention programs need to be developed and tested

Kriyobalon kateter ablasyonu uygulanan hastalarda serum osteopontin seviyeleri ile atriyum fibrilasyonu nüksü arasındaki ilişki

Objective: Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with increased morbidity and mortality. Atrial fibrosis augments recurrence rate following AF catheter ablation. Osteopontin is a multifunctional molecule involved in several pathophysiological pathways, including fibrosis. Presently described is investigation of relationship between serum osteopontin level and AF recurrence after AF cryoablation.Methods: The study was designed to be prospective and observational; 60 patients with paroxysmal (n=47) and persistent (n=13) AF were included. Osteopontin level was measured both before and 6 months after AF ablation with cryoballoon.Results: Preprocedure and postprocedure osteopontin level did not differ between the 2 groups of AF patients (p=0.286, p=0.493, respectively). Postprocedure osteopontin level was significantly higher compared with preprocedure value (32.18 ng/mL vs 15.58 ng/mL; p=&lt;0.001). Left atrial diameter, AF type, and preprocedure osteopontin level were related to AF recurrence (p&lt;=0.05). An age-adjusted multivariate logistic regression analysis was conducted to determine independent predictors of AF recurrence. Among these, AF type (?=2.211; p=0.004; odds ratio [OR]: 9.124; 95% confidence interval [CI]: 2.026-41.094) was found to be the most important factor related to AF recurrence. Preprocedure osteopontin level also predicted AF recurrence independently (?=0.059; p=0.048; OR: 1.061; 95% CI 1.001-1.125).Conclusion: Study results revealed persistency of AF and high preprocedure osteopontin level independently predicted AF recurrence in patients undergoing cryoballoon AF ablation. Association of a biochemical marker with AF recurrence might be beneficial to selection of appropriate patients for cryoballoon procedure and assessment of long-term procedural success.Amaç: Atriyum fibrilasyonu (AF) mortalite ve morbidite artışı ile ilişkili en sık rastlanan ritm bozukluğudur. Atriyum fibrozu, AF'nin kateter ablasyonu sonrası nüks oranını artırır. Osteopontin, fibrozu da içeren çeşitli fizyopatololojik süreçlerde görev alan çok fonksiyonlu bir moleküldür. Atriyum fibrilasyonu kriyoablasyonu sonrasında serum osteopontin seviyeleri ile AF nüksü arasındaki ilişkiyi araştırdık.Yöntemler: Çalışmamız ileriye dönük ve gözlemsel olarak tasarlandı; nöbetli (n=47) ve sürekli (n=13) AF'si olan 60 hasta çalışmaya dahil edildi. Serum osteopontin seviyeleri AF kriyoablasyonu işlem öncesi ve işleminden altı ay sonra ölçüldü.Bulgular: İki AF hasta grubuna göre işlem öncesi ve sonrası osteopontin seviyeleri arasında farklılık saptanmadı (sırasıyla, p=0.286, p=0.493). İşlem sonrası osteopontin seviyeleri, işlem öncesi seviye ile kıyaslandığında anlamlı olarak yüksekti (32.18 ng/mL ve 15.58 ng/mL; p=<0.001). Sol atriyum çapı, AF tipi, işlem öncesi osteopontin seviyeleri AF ablasyonu sonrası nüks ile ilişkili saptandı (p<=0.05). Atriyum fibrilasyonu nüksünün bağımsız risk öngördürücülerini tespit etmek için yaşa göre düzeltilmiş çok değişkenli lojistik regresyon analizi yapıldı. Bunların arasında, AF tipinin (?=2.211 p=0.004, OO: 9.124, %95 GA [2.026-41.094]) AF nüksü açısından en önemli öngördürücü olduğu tespit edildi. İşlem öncesi osteopontin seviyeleri de AF nüksünü bağımsız olarak öngördü (?=0.059, p=.048, OO: 1.061, %95 GA [1.001-1.125]).Sonuç: Çalışmamızda, AF'nin sürekliliği ve daha yüksek işlem öncesi osteopontin seviyeleri AF kriyobalon ablasyon tedavisi yapılan hastalarda nüksü bağımsız olarak öngördürmüştür. Biyokimyasal bir belirtecin kriyoablasyon sonrası nüks ile ilişkili olması, ablasyon tedavisi için uygun hastaların seçimi ve uzun dönem işlem başarısını değerlendirmede faydalı olabilir