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OBJECTIVE: To appraise the relationship between the length of exposure to epidural analgesia and the risk of non-spontaneous birth, and to identify additional risk factors. This study is framed within the MidconBirth project. STUDY DESIGN: A multicentre prospective study was conducted between July 2016 and November 2017 in three maternity hospitals in different Spanish regions. The independent variable of the study was the length of exposure to epidural analgesia, and the dependent variable was the type of birth in women with uncomplicated pregnancies. The data was analyzed separately by parity. A multivariate logistic regression was performed. The odds ratios (OR), using 95% confidence intervals (CI) were constructed. MAIN OUTCOME MEASURES: During the study period, 807 eligible women gave birth. Non-spontaneous births occurred in 29.37% of the sample, and 75.59% received oxytocin for augmentation of labour. The mean exposure length to epidural analgesia when non-spontaneous birth happened was 8.05 for primiparous and 6.32 for multiparous women (5.98 and 3.37 in spontaneous birth, respectively). A logistic regression showed the length of exposure to epidural during labour was the major predictor for non-spontaneous births in primiparous and multiparous women followed by use of oxytocin (multiparous group). CONCLUSIONS: The length of exposure to epidural analgesia during labour is associated with non-spontaneous births in our study. It highlights the need for practice change through the development of clinical guidelines, training programs for professionals and the continuity of midwifery care in order to support women to cope with labour pain using less invasive forms of analgesia. Women also need to be provided with evidence-based information.

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This study investigated how personality traits are related to postnatal depression 2 weeks after giving birth and whether these relations are mediated by postnatal anxiety, measured after 3-4 days after giving birth and moderated by the type of birth. New mothers (N = 672, Mage = 29.33) completed scales assessing their personality traits, postnatal anxiety, and postnatal depression 3 or 4 days after giving birth (T1). They also reported postnatal depression 2 weeks after giving birth (T2). Path analysis indicated that postnatal anxiety explained the link between personality traits (i.e., neuroticism) and postnatal depression 2 weeks after childbirth. The type of birth moderated the relation among, personality traits, postnatal anxiety and depression. Neuroticism and consciousness, in the natural birth's group, and neuroticism and agreeableness, in the cesarean birth's group, were associated with postnatal depression. Further, anxiety explained the relation between neuroticism and postnatal depression in both natural and cesarean birth groups. In addition, postnatal anxiety mediated the relation between extraversion and postnatal depression in the cesarean birth group. Our findings highlight that postnatal anxiety is a potential mechanism explaining how personality traits (i.e., neuroticism, extraversion) are related to postnatal depression, and that these relations may depend on the type of childbirth.

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The management of lambs during the neonatal period has been studied in several researches due to the vital and hormonal organic adaptations undergone by the calf after birth. However, gender, number of pups and type of delivery play an important role in understanding neonatal vigor. The study of these groups with the monitoring of clinical evolution and cortisol metabolism becomes an indispensable subsidy for a better understanding of this neonatal phase, aiming to minimize the losses generated. The objective of this study was to evaluate the influence of gender, number of pups and type of delivery in the prognosis of neonatal vigor of lambs through clinical and cortisol diagnosis. Thirty crossbred Santa Inês lambs with Dorper in the neonatal phase were divided into three groups: male and female, number of pups (single and twin) and type of delivery (eutocic and dystocic). In each group, clinical evaluation of heart and respiratory rate, rectal temperature, Apgar score and weight were performed; and with the exception of cortisol, all evaluations were performed at fifteen and sixty minutes, as well as at twelve and twenty-four hours. In addition, blood samples were collected for cortisol dosage obtained in two moments at fifteen and sixty minutes using the radioimmunoassay technique. Among the three experimental groups related to lamb vigor, the heart rate was the only one that showed lower mean values (P<0.05) at twenty-four hours in the male group 90.00±20.20bpm, twins 96.44±20.02bpm and eutocic 93.25±18.11bpm. Differences in respiratory rate values were observed in the eutocic group (64.00±14.75mpm) at twenty-four hours. In the group of males there was a significant reduction in body temperature during the evaluation moments (P<0.05). Lambs from the group of twins showed lower body weight during the evaluations. At both times the analysis of serum cortisol was less than at sixty minutes. It was concluded that soon after the birth there were marked changes in the physiological parameters and weight of Santa Inês lambs, but were not enough to cause negative effects on the vigor of the neonates, indicating the occurrence of effective neonatal adaptation capacity in this species.(AU)

O manejo dos cordeiros durante o período neonatal tem sido objeto de estudo em diversas pesquisas devido às adaptações orgânicas vitais e hormonais sofridas pela cria após o parto. Todavia, o gênero, número de filhotes e o tipo de parto parecem desempenhar um papel importante para melhor compreensão do vigor neonatal. Além disso, o estudo destes grupos com o acompanhamento da evolução clínica e do metabolismo do cortisol torna-se um subsidio indispensável para melhor compreensão dessa fase neonatal, visando minimizar as perdas geradas. Dessa forma, o objetivo do presente trabalho foi avaliar a influência do gênero, número de filhotes e tipo de parto na apresentação do vigor neonatal dos cordeiros através do diagnostico clinico e de cortisol. Foram utilizados trinta cordeiros mestiços da raça Santa Inês com Dorper em fase neonatal divididos em três grupos: gênero (macho e fêmea), número de filhotes (único e gemelar) e tipo de parto (eutócico e distócico). Em cada grupo, foi realizada a avaliação clínica da frequência cardíaca e respiratória, temperatura retal, escore Apgar e peso; e com a exceção do cortisol, todas as avaliações foram realizadas aos quinze e sessenta minutos, como também às doze e vinte e quatro horas. Adicionalmente, procedeu-se com a coleta de amostras de sangue total para dosagem de cortisol obtida em dois momentos aos quinze e sessenta minutos através da técnica de radioimunoensaio. Dentre os três grupos experimentais relacionados com vigor dos cordeiros, a frequência cardíaca foi a única que evidenciou menores médias (P<0,05) às vinte e quatro horas no grupo dos machos 90,00±20,20bpm, gêmeos 96,44±20,02bpm e eutócicos 93,25±18,11bpm. Observou-se no grupo eutócico diferenças nos valores da frequência respiratória de 64,00±14,75mpm às vinte e quatro horas. No grupo dos machos houve redução significativa na temperatura corpórea durante os momentos de avaliação (P<0,05). Cordeiros do grupo de gêmeos demonstraram menor peso corpóreo durante as avaliações. Em ambos momentos a análise do cortisol sérico demonstrou se menor aos sessenta minutos. Pôde se concluir que logo após o parto ocorreram alterações marcantes nos parâmetros fisiológicos e peso de cordeiros Santa Inês, porém não foram suficientes para causar efeitos negativos sobre o vigor dos neonatos, indicando a ocorrência de efetiva capacidade de adaptação neonatal nesta espécie.(AU)

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AIM: The aim of this study was to determine the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. BACKGROUND: There is insufficient evidence pertaining to the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. INTRODUCTION: The purpose of antenatal education is to help couples make the right decisions during delivery. Through antenatal education, couples prepare themselves for delivery. METHODS: This is a quasi-experimental and prospective study that employs a pre- and post-education model. In total, 192 pregnant women (education group, n = 69 and control group, n = 123) participated in the study. Data were collected using the pregnancy identification form: the Prenatal Self-Evaluation Questionnaire and a version of the Wijma Delivery Expectancy/Experience Questionnaire. RESULTS: Prior to participating in the study, the education group and control group had similar levels of acceptance of pregnancy and identification with motherhood role, whereas a significant difference was found in their fear of childbirth levels. When surveyed again after receiving education, the two groups' levels of acceptance of pregnancy and fear of childbirth were found to be significantly different. However, they had similar levels of identification with the motherhood role. CONCLUSION: Antenatal education appears to increase the acceptance of pregnancy, does not affect the identification with motherhood role and reduces the fear of childbirth. IMPLICATIONS FOR NURSING AND HEALTH POLICY: A systematic antenatal education programme, as part of routine antenatal care services, would help reduce the rate of interventional labour and facilitate pregnant women's conscious participation in the act of labour by reducing their fear of childbirth.

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PURPOSE: To compare the breast-feeding outcomes and breast-feeding self-efficacy, in the first 24 postpartum hours, of mothers who underwent vaginal birth, cesarean birth with epidural anesthesia, and cesarean birth with general anesthesia. METHODS: A comparative study was conducted in Turkey. A total of 334 mothers participated. Data were evaluated through descriptive data form, breast-feeding outcomes form, and the Breastfeeding Self-Efficacy Scale. FINDINGS: It was observed that the mothers who had cesarean birth with general anesthesia experienced more breast-feeding problems. With regard to breast-feeding self-efficacy, all the groups were similar. CONCLUSION: For reducing breast-feeding problems, nurses should provide more care and support to mothers undergoing cesarean birth. Therefore, the fact that the breast-feeding self-efficacy was similar among the groups might be related to culture.

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Data of weaning weights (WW) from 2 172 Suffolk lambs with complete genealogical information, obtained from a flock in central Mexico from 1992 to 2004, were analyzed using mixed linear models with direct and maternal effects, to generate correction factors and to compare different methods for the adjustment of sex, type of birth and age of the mother effects. The methods compared were: analysis of weaning weights with a complete mixed model (PDMOD), analysis of WW preadjusted to 68 days and for sex and age of the mother-type of birth with factors developed from this population (PD68PRE), analysis of WW adjusted to 68 days with a complete model (PD68MOD) and analysis of WW preadjusted to 68 days and for sex, age of the mother and type of birth with factors developed for the Suffolk population of the United States of America (PD68USA). The effects of year of birth, sex, type of birth, age of the mother, year of birth x age of the mother interaction and the linear and quadratic effects of weaning age were all significant (P < 0.01). The inclusion of all the effects in the model gave slightly smaller residual coefficients of variation with reductions < 0.51 %, compared to preadjusted data with correction factors generated either in the flock or adapted from those suggested for the Suffolk population of the United States of America. Small differences between methods in the ranking of the animals according to the genetic evaluations based on empirical BLUP's for direct and maternal genetic effects were found, with Spearman's correlation values > 0.96.

Datos de pesos al destete (PD) de 2 172 corderos Suffolk con información genealógica completa, obtenidos de 1992 a 2004 en un rebaño en el centro de México, fueron analizados usando modelos lineales mixtos con efectos directos y maternos, para generar factores de corrección y comparar diferentes métodos de ajuste para los efectos de sexo, tipo de nacimiento y edad de la madre. Los métodos comparados fueron: análisis de PD con un modelo completo (PDMOD), análisis de PD preajustados a 68 días y para sexo, edad de la madre-tipo de nacimiento con factores desarrollados a partir de esta población (PD68PRE), análisis de PD ajustados a 68 días con un modelo completo (PD68MOD) y análisis de PD preajustados a 68 días y para sexo, edad de la madre y tipo de nacimiento con factores desarrollados para la población Suffolk de los Estados Unidos de América (PD68USA). Los efectos de año de nacimiento, sexo, tipo de nacimiento, edad de la madre, interacción año de nacimiento x edad de la madre y edad al destete lineal y cuadrática fueron significativos (P < 0.01). La inclusión de todos los efectos en el modelo dio coeficientes de variación residual ligeramente menores, con reducciones < 0.51%, en comparación con el uso de datos preajustados con factores de corrección generados en el propio rebaño o adaptados de los recomendados para la población Suffolk de los Estados Unidos de América. Las diferencias entre los métodos en la jerarquización de los animales de acuerdo con las evaluaciones genéticas con los BLUP empíricos de los efectos directos y maternos fueron pequeñas, con valores de correlaciones de Spearman > 0.96.