Using data from patient records gathered at routine 4-week postnatal visits (N=209), the authors sought to determine possible correlations between incidence of postpartum depression and the following patient characteristics: age, breastfeeding status, tobacco use, marital status, history of depression, and method of delivery. Formula feeding in place of breastfeeding, a history of depression, and cigarette smoking were all significant risk factors for an Edinburgh Postnatal Depression Scale score of 13 or higher, indicating probable postpartum depression.
The authors compared postpartum maternal and neonatal outcomes resulting from supine vs nonsupine birthing positions in women at two obstetrics practices. In one practice, parturients (n=100) used only the supine position and were attended by physicians. In the other practice, parturients (n=98) used any or all of three nonsupine positions and were attended by nurse midwives. The authors report that infants born to mothers in nonsupine positions were delivered with significantly less tearing of the perineum (P<.001) and less vulvar edema (P<.001), indicating that nonsupine positions have clinical advantages.
The authors summarize the reported effects of breastfeeding on the development of the infant's immune system and discuss possible consequences to later immunologic health when breastfeeding is discontinued prematurely.
Injuries to the brachial plexus in neonates are of growing concern, mainly because they are an increasing cause of legal action in medical malpractice cases. The authors review current medical and legal principles and make a number of recommendations to help practitioners reduce their risk of malpractice lawsuits stemming from the care of patients with these injuries, including: increasing one's awareness of nontraumatic causes, making sure that appropriate testing is performed for infants whose conditions fail to improve within several months after birth, and taking a proactive approach in discussing brachial plexus injuries with patients' families.
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