Postpartum depression is a serious and frequent condition that affects a significant proportion of new mothers in developed countries. Despite its high prevalence and proven deleterious outcomes for both mother and child, there remains an increasing need to expand our knowledge regarding new methods that ensure the discovery of at-risk patients. Many theories have been developed over the years, mainly focusing on hormonal imbalances that occur after childbirth. This review has the purpose to analyze the existing literature and to summarize the latest findings on neuroactive molecules which may predict postpartum depression in new mothers.
Objective. We aim to evaluate the implications of cesarean delivery compared to natural birth by analyzing newborns’ systemic and cerebral oxygenation levels during the first 10 minutes of life. Design. This paper presents a 4-year prospective cohort study. Setting. Polizu Maternity, "Alessandrescu-Rusescu" National Institute for Mother and Child's Protection, Bucharest, Romania. Patients. Randomly selected pregnant women and their fetuses. Interventions. During the 10 min following umbilical cord clamping, regional cerebral oxygen saturation (rcSO2) was measured using the INVOS 5100 device and peripheral oxygen saturation (SpO2) was determined using the Masimo SET pulse oximeter in neonates from cesarean and natural deliveries. Main outcome measures. The cerebral fractional tissue oxygen extraction (cFTOE) in the first 10 minutes of life was calculated based on these values. Results. Newborns delivered vaginally showed higher rcSO2 levels at 1 minute of life than those born via C-section (40.5 ± 16.5% vs 33.7 ± 14.8%, AUC = 0.625; IC 95%: 0.506 - 0.743; p = 0.043). Neonatal cFTOE at 1 minute of life was significantly higher in caesarean-delivered newborns versus naturally born neonates (0.40 ± 0.25 vs 0.50 ± 0.19, p = 0.03; AUC = 0.638; IC 95%: 0.517-0.758; p = 0.023). Conclusions. Prelabor cesarean delivery seemingly plays a significant role in the process of fetal and neonatal cerebral oxygenation immediately postnatally, which is highlighted by lower rcSO2 and higher cFTOE values. Cerebral oxygen saturation monitoring in the delivery room allows the optimization of oxygen therapy in order to prevent the consequences of hypoxia or hyperoxia.
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