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Postpartum Office Visit

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821. Efficacy and Safety of SR58611A in Patients With Major Depressive Disorder

. A Safety Follow up Visit is scheduled 1 week after the acute and extension period, or early termination. Escitalopram, a selective serotonin reuptake inhibitor (SSRI), an approved treatment for MDD, is chosen as a positive control agent in this study. The dose of 10 mg is within the approved dose range with no need for dose adjustment in elderly patients. This trial is designed to formally compare the efficacy, safety, and tolerability of SR58611A to placebo. Escitalopram is used as a positive control (...) for a continuous total duration of at least 2months. Exclusion Criteria: Main exclusion criteria: 1. Patients at immediate risk for suicidal behavior 2. Patients with a MDE with psychotic features, catatonic features, seasonal pattern or postpartum onset 3. The duration of the current depressive episode is greater than 2 years 4. Patients whose current depressive episode is secondary to a general medical condition 5. Patients with a lifetime history of (1) bipolar disorder, (2) psychotic disorder, (3

2005 Clinical Trials

822. Newborn early discharge revisited: are California newborns receiving recommended postnatal services? (PubMed)

study using a 1999 postpartum survey in California.A total of 2828 infants of mothers with medically low-risk singleton births.Rates of early discharge (office visit within 2 days of early discharge).Overall, 49.4% of newborns were discharged early. Of these, 67.5% had untimely follow-up. The odds of early discharge were greater with lower incomes: the adjusted odds ratios (AORs

2003 Pediatrics

823. Maternal depressive symptoms and children's receipt of health care in the first 3 years of life. (PubMed)

Maternal depressive symptoms and children's receipt of health care in the first 3 years of life. Maternal depression is widely recognized to negatively influence mother-child interactions and children's behavior and development, but little is known about its relation to children's receipt of health care.To determine if maternal depressive symptoms reported at 2 to 4 and 30 to 33 months postpartum are associated with children's receipt of acute and preventive health care services in the first 30 (...) months.Cohort study of data collected prospectively as part of the National Evaluation of Healthy Steps for Young Children (HS). Data sources included medical records abstracted for the first 32 months, enrollment questionnaires, and parent interviews when children were 2 to 4 and 30 to 33 months old. Acute care use included hospitalizations and emergency department visits. Preventive care included well-child visits and vaccinations. Maternal depressive symptoms were assessed by using the Center

2005 Pediatrics

824. Epidemiologic Study of Reproductive Outcome in Women With Systemic Lupus Erythematosus

postpartum, and visit 5 at 6 months postpartum. Visits 4 and 5 include an infant exam for growth and morphologic parameters; these visits occur on the same schedule if there is a miscarriage or stillbirth. Patients not currently pregnant are randomly chosen to be followed as controls. These patients undergo a review of current pregnancy status and measures of disease activity, including SLAM, every 3 months for 5 visits. Study Design Go to Layout table for study information Study Type : Observational (...) Resources (NCRR) Collaborators: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Northwestern University Information provided by: Office of Rare Diseases (ORD) Study Details Study Description Go to Brief Summary: OBJECTIVES: I. Evaluate whether pregnancy is an independent risk factor that affects disease activity in women with systemic lupus erythematosus. II. Evaluate whether maternal disease activity is a risk factor for adverse pregnancy outcome. Condition or disease

2000 Clinical Trials

825. Commentary from Coeur d'Alene: one baby-or two? (PubMed)

, the reimbursement for maternity care is cut to the minimum, and there is no paid-for postpartum vacation. If a 3rd pregnancy occurs, community pressure is brought to bear and there must be an abortion with a permanent sterilization to follow. This approach can be successful in a communist nation where the government controls the pursestrings and writes the paychecks. In the Philippines the efforts have been directed toward a positive program of conception control. A Barangay Supply Point Officer (BSPO) works (...) . An instructive example of how to enforce population control is China. Their solution aims at the pocketbooks of the Chinese workers. When a couple marries, a government representative visits and advises that the good of the country lies in the careful limitation of family size. During the 1st pregnancy, all care is free, and the mother is given a generous amount of time off with full pay. If a 2nd pregnancy occurs, an abortion is urged. Should the couple choose to go through with the pregnancy

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1983 Western Journal of Medicine

826. Reducing maternal smoking and relapse: long-term evaluation of a pediatric intervention. (PubMed)

Reducing maternal smoking and relapse: long-term evaluation of a pediatric intervention. Pediatric well-care visits provide a clinical opportunity to counsel new mothers about their smoking and the deleterious effects of environmental tobacco smoke (ETS) on infant health.Forty-nine Oregon pediatric offices enrolled 2,901 women who were currently smoking or had quit for pregnancy, using a brief survey at the newborn's first office visit. Randomly assigned offices provided advice and materials (...) to mothers at each well-care visit during the first 6 months postpartum to promote quitting or relapse prevention.The intervention reduced smoking (5.9% vs 2.7%) and relapse (55% vs 45%) at 6-month follow-up, but logistic regression analysis at 12 months revealed no significant treatment effect. The intervention had a positive effect on secondary outcome variables, such as readiness to quit and attitude toward and knowledge of ETS. Multiple logistic regression analysis indicated that husband/partner

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1997 Preventive Medicine Controlled trial quality: uncertain

827. Translating Research Into Practice for Postpartum Depression

Information provided by: Olmsted Medical Center Study Details Study Description Go to Brief Summary: This is a study to assess the impact of introducing screening and planned follow up for postpartum depression. All women ages 18 to 45 who speak English or Spanish who come to the enrolled community family medicine offices will either be given usual care or screened using the Edinburgh Postnatal Depression Screening tool. If the EDPS score is high the women will be given the PHQ-9 to more clearly identify (...) the specific likelihood of being depressed. Women who are determined to be depressed will be treated with medication or counseling based on the preference of the women and their physicians. Women will be followed through nurse initiated phone calls and visits to the physicians office. Outcomes include the level of depression symptoms, measure of comfort with parenting, and satisfaction with partner relationships comparing baseline levels with those at 6 and 12 months from the usual care and intervention

2007 Clinical Trials

828. Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: a prospective, randomized, open trial of 226 mother-infant pairs. (PubMed)

Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: a prospective, randomized, open trial of 226 mother-infant pairs. Despite growing evidence of the benefits of prolonged breastfeeding for mother and infant health, the rate of breastfeeding at infant age of 6 months remains below the Healthy People 2010 goal. The greatest decrease in the breastfeeding rate occurs during the first 4 postpartum weeks. Mothers who discontinue breastfeeding (...) of this study was to determine whether attending an early, routine, preventive, outpatient visit delivered in a primary care physician's office would improve breastfeeding outcomes.The study was a prospective, randomized, parallel-group, open trial.Participants were recruited at a level 3 maternity facility, with an average of 2000 births per year, in France.A total of 231 mothers who had delivered a healthy singleton infant (gestational age: > or =37 completed weeks) and were breastfeeding on the day

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2005 Pediatrics Controlled trial quality: predicted high

829. Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures. (PubMed)

Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures. Concern about harm to newborns from early postpartum discharges led to laws establishing minimum hospital stays in the mid-1990s. We evaluated the effects of an early-discharge protocol (a hospital stay of one postpartum night plus a home visit) in a health maintenance organization (HMO) and a subsequent state law guaranteeing a 48-hour hospital stay.Using interrupted-time-series (...) analysis and data on 20,366 mother-infant pairs with normal vaginal deliveries, we measured changes in length of stay, newborn examinations on the third or fourth day of life, and office visits, emergency department visits, and hospital readmissions for newborns. We also examined expenditures for hospitalizations and home-based care.The early-discharge program increased the rate of stays of less than two nights from 29.0 percent to 65.6 percent (P<0.001). The rate declined to 13.7 percent after

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2002 NEJM

830. Effect of early postpartum teaching on primiparas' knowledge of infant behavior and degree of confidence. (PubMed)

at home two weeks postnatally; control mothers (n = 13) received neither teaching nor a checklist. At a 4-week postnatal office visit, experimental mothers had more knowledge about infant behavior than either the contrast or control mothers. There was no difference among the groups regarding maternal confidence in interpreting behavioral cues of their own infant. Contrast mothers reported wanting information about topics included in the teaching intervention. (...) Effect of early postpartum teaching on primiparas' knowledge of infant behavior and degree of confidence. The purpose of this experimental study was to determine the effectiveness of teaching primiparous mothers about infant behavior. Experimental mothers (n = 17) received a teaching intervention representative of the Brazelton Neonatal Behavioral Assessment Scale when their infants were 2 weeks old; contrast mothers (n = 16) completed a Newborn Information Checklist about infant behavior

1986 Research in nursing & health

831. Reducing smoking during pregnancy and postpartum: physician's advice supported by individual counseling. (PubMed)

or reducing their cigarette consumption by 50% or more at their second visit (43% vs 29%, P = 0.02), at their 36th-week visit (40% vs 25%, P < 0.01), and at 1 year postpartum (26% vs 14%, P = 0.02).Physician training on how to gain a pregnant smoker's commitment to change her smoking behavior, an office prompt system, and individualized smoking behavior change counseling show promise in reducing smoking during pregnancy and postpartum, but practical methods to assist pregnant smokers between regular (...) care or to receive brief advice to stop smoking and a quit smoking booklet at their first visit. Smoking status was measured by self-report, exhaled carbon monoxide, and urinary cotinine.Compared with usual care, greater proportions of intervention group women reported not smoking at the 36th-week visit (14% vs 10%) and at 1 year postpartum (18% vs 11%), but these differences were not significant. However, significantly greater proportions of intervention group women reported either not smoking

1998 Preventive Medicine Controlled trial quality: uncertain

832. Pediatric office-based smoking intervention: impact on maternal smoking and relapse. (PubMed)

Pediatric office-based smoking intervention: impact on maternal smoking and relapse. To determine the impact of a brief smoking intervention delivered by pediatricians in the context of usual well baby office visits on postnatal maternal smoking and relapse.Forty-nine private pediatric practices including 128 practitioners.Randomization of pediatric practices into minimal and extended intervention sites with all enrolled mothers of newborns within a practice receiving the same level (...) of intervention.Smoking mothers in minimal condition received a hospital packet containing written information about passive smoking and a letter advising them to quit. Those in extended condition received the hospital packet plus oral and written advice at usual well baby visits: 2 weeks, 2, 4, and 6 months.Smoking and relapse rates at 6 months postpartum, demographics associated with smoking status, attitudes, and knowledge in regard to passive smoking, and recall surveys of mothers in regard to receiving advice

1995 Pediatrics Controlled trial quality: uncertain

833. Reduced schedule of antenatal visits. Effect of fewer visits on postnatal depression is important. (PubMed)

Reduced schedule of antenatal visits. Effect of fewer visits on postnatal depression is important. 8688786 1996 08 29 2018 11 13 0959-8138 313 7050 1996 Jul 20 BMJ (Clinical research ed.) BMJ Reduced schedule of antenatal visits. Effect of fewer visits on postnatal depression is important. 167-8; author reply 169 Tincello D D eng Comment Letter England BMJ 8900488 0959-8138 AIM IM BMJ. 1996 Mar 2;312(7030):546-53 8595286 Depression, Postpartum Female Humans Office Visits Patient Satisfaction

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1996 BMJ : British Medical Journal

834. A randomized trial of a program of early postpartum discharge with nurse visitation. (PubMed)

A randomized trial of a program of early postpartum discharge with nurse visitation. Our purpose was to compare an early postpartum discharge program versus standard postpartum care.A randomized controlled trial in a 637-bed university hospital included 175 healthy women recruited at 32 to 38 weeks gestation from physicians' offices and sonograms. Experimental intervention consisted of discharge 6 to 36 hours post partum with nursing care available by telephone or at home at 34 to 38 weeks (...) ' gestation and at < or = 48 hours and at 3, 5, and 10 days post partum. The control included a postpartum stay of 48 to 72 hours and standard follow-up.At 1 month no significant differences were seen in perceived maternal competence (Experimental-Control = 4.3 points [95% confidence interval-7.7 to 16.3]), infant weight gain (1.2 gm/ day [-2.8 to 5.2]); identification of significant neonatal hyperbilirubinemia (rate ratio 0.50 [0.10 to 2.51]), infant utilization of health services (rate ratio 0.88 [0.45

1997 American journal of obstetrics and gynecology Controlled trial quality: predicted high

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