Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe

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Vulnerable migrant women and postnatal depression: A case of invisibility in maternity services?

YesVulnerable migrant women are at an increased risk of developing postnatal depression, compared with the general population. Although some symptoms are the same as in other pregnant women, there are specific reasons why vulnerable migrant women may present differently, or may not recognise symptoms themselves. Factors associated with migration may affect a woman’s mental health, particularly considering forced migration, where a woman may have faced violence or trauma, both in her home country and on the journey to the UK. Vulnerable migrant women engage less with maternity care than the average woman for reasons including a lack of knowledge of the UK healthcare system, fear of being charged for care, or fear that contact with clinicians will negatively affect their immigration status. This article explores the issues surrounding vulnerable migrant women that increase their risk of developing postnatal depression and presents reasons why this may go unrecognised by health professionals such as midwives

Postpartum psychiatric disorders

Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These disorders can include postpartum depression and anxiety, which are relatively common, and the rare but more severe postpartum psychosis. In addition, other PPDs can include obsessive–compulsive disorder, post-traumatic stress disorder and eating disorders. The aetiology of PPDs is a complex interaction of psychological, social and biological factors, in addition to genetic and environmental factors. The goals of treating postpartum mental illness are reducing maternal symptoms and supporting maternal–child and family functioning. Women and their families should receive psychoeducation about the illness, including evidence-based discussions about the risks and benefits of each treatment option. Developing effective strategies in global settings that allow the delivery of targeted therapies to women with different clinical phenotypes and severities of PPDs is essential

Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials

Background and objective: the effect of exercise in prevention of low back and pelvic girdle pain during pregnancy is uncertain. This study aimed to assess the effect of exercise on low back pain, pelvic girdle pain and associated sick leave.Databases and data treatment: literature searches were conducted in PubMed, EMBASE, Cochrane Library, Google Scholar, ResearchGate and ClinicalTrials.gov databases from their inception through May 2017. Randomized controlled trials (RCTs) were eligible for inclusion in the review if they compared an exercise intervention with usual daily activities and at least some of the participants were free from low back pain and/or pelvic girdle pain at baseline. Methodological quality of included studies was evaluated using the Cochrane Collaboration's tool. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed.Results: eleven randomized controlled trials (2347 pregnant women) qualified for meta-analyses. Exercise reduced the risk of low back pain in pregnancy by 9% (pooled risk ratio (RR) = 0.91, 95% CI 0.83–0.99, I2 = 0%, seven trials, N = 1175), whereas it had no protective effect on pelvic girdle pain (RR = 0.99, CI 0.81–1.21, I2 = 0%, four RCTs, N = 565) or lumbopelvic pain (RR = 0.96, CI 0.90–1.02, I2 = 0%, eight RCTs, N = 1737). Furthermore, exercise prevented new episodes of sick leave due to lumbopelvic pain (RR = 0.79, CI 0.64–0.99, I2 = 0%, three RCTs, N = 1168). There was no evidence of publication bias.Conclusion: exercise appears to reduce the risk of low back pain in pregnant women, and sick leave because of lumbopelvic pain, but there is no clear evidence for an effect on pelvic girdle pain.Significance: exercise has a small protective effect against low back pain during pregnancy

Breastfeeding rates in immigrant and non-immigrant women : a systematic review and meta-analysis

Breastfeeding benefits mothers and infants. While immigration in many regions has increased in the last three decades, it is unknown whether immigrant women have better breastfeeding outcomes than non‐immigrants. The aim of this study was to conduct a systematic review and meta‐analysis to determine whether breastfeeding rates differ between immigrant and non‐immigrant women. We searched Medline, Embase, PsycINFO, CINAHL, and Google Scholar, 1950 to 2016. We included peer‐reviewed cross‐sectional and cohort studies of women aged ≥ 16 years that assessed and compared breastfeeding rates in immigrant and non‐immigrant women. Two independent reviewers extracted data using predefined standard procedures. The analysis included 29 studies representing 1,539,659 women from 14 countries. Immigrant women were more likely than non‐immigrants to initiate any (exclusive or partial) breastfeeding (pooled adjusted prevalence ratio [aPR] 1.13, 95% confidence interval [CI] 1.07‐1.19; 11 studies). Exclusive breastfeeding initiation was higher but borderline significant (aPR 1.20, 95% CI 1.00‐1.45; 5 studies, p = 0.056). Immigrant women were more likely than non‐immigrants to continue any breastfeeding between 12 and 24 weeks postpartum (pooled adjusted risk ratio [aRR] 2.04, 95% CI 1.79‐2.32; 3 studies) and > 24 weeks (aRR 1.33, 95% CI 1.02‐1.73; 6 studies), but not exclusive breastfeeding. Immigrant women are more likely than non‐immigrants to initiate and maintain any breastfeeding but exclusive breastfeeding remains a challenge for both immigrants and non‐immigrants. Social and cultural factors need to be considered to understand the extent to which immigrant status is an independent predictor of positive breastfeeding practices