Changes in pregnancy-related discomforts in women from the third-trimester pregnancy to 1 year postpartum

Abstract

The present study aimed to clarify the changes in the incidence and frequency of pregnancy-related discomforts in the period from the third-trimester pregnancy to 1 year postpartum, and factors associated with the symptoms. MethodsThe participants were pregnant women who visited the obstetrics and gynecology outpatient departments of four hospitals for medical examinations or maternity classes in Hiroshima, Japan. A questionnaire survey was administered five times longitudinally: during the pregnancy period, at discharge, and at 1 month, 4 months, and 1 year after childbirth. The contents of the survey consisted of the existence and the frequency of 29 frequently experienced discomforts of pregnancy, type of delivery, feeding condition, childcare burden scale, Japanese version of maternal attachment inventory (MAI-J), and Japanese version of Edinburgh postnatal depression scale (EPDS). We performed one-way analysis of variance for analyzing the changes in the number of symptoms from pregnancy to postpartum and chi-square tests for analyzing the prevalence of each symptom. The Pearson product factor correlation coefficient and unpaired t-tests were used for analyzing the relation between the number of symptoms and the factors affecting postpartum health. ResultsQuestionnaires were distributed to 1566 women in the pregnancy period, and we collected third-trimester data of 681 women and used data of 422 women. Questionnaires were also distributed to the women during the following postpartum periods: time of discharge, 126; 1 month after childbirth, 88; 4 months after childbirth, 79; and 1 year after childbirth, 70. The number of pregnancy-related symptoms were decreased as time passed by (F=130.93, p<0.01). The prevalence of 22 symptoms significantly decreased after childbirth, while the prevalence of three symptoms increased and that of four symptoms remained unaltered. The number of symptoms at the time of discharge and 1 month after childbirth were significant correlated with the EPDS score (r=0.39-0.58, p<0.01) and the childcare burden scale (r=0.30-0.44, p<0.05) from 1 month to 1 year after childbirth. ConclusionThe findings of this study confirm that some pregnancy-related discomforts continue to postpartum and that the number of symptoms in postpartum is associated with postpartum depression and the stress of postnatal care. We thus showed the importance of maternal care during pregnancy as it affects childcare later on. Childcare starts from pregnancy. Thus, a smooth transition to childcare is possible only if pregnancy-related discomforts such as "minor troubles" are not taken lightly, as women require all the physical, mental, and emotional care right from the beginning of pregnancy to be strong and healthy in all aspects of the postnatal phase.

Psychosocial Experiences Related to Dietary Behavior of Japanese Lactating Women: A Qualitative Study

“…For their bodies, they had a desire to have good meals for their own health and body shape. Previous studies showed that physical problems, such as mastitis, anemia, constipation, and insufficient sleep, were common in the first month postpartum [ 22 , 23 , 26 , 30 , 31 ]. The perception of these physical vulnerabilities increased our participants’ desire to prevent mastitis and their recognition of the risk of poor health, which reinforced their desire for a healthy diet.…”

“…The reasons included a lack of time, their own diet taking lower priority, physical discomfort, and not being good at cooking. Previous studies have shown that few women in the first month postpartum were able to settle into their new lifestyle patterns [ 41 ] due to reduced sleep time, physical symptoms, such as fatigue and back pain, and the strain of childcare [ 23 , 30 , 31 , 42 ]. Our participants also felt that they experienced physical or mental difficulties in preparing meals due to their living conditions.…”

“…This energy expenditure associated with breast milk production would have increased the appetites of our participants. In previous studies [ 23 , 39 ], 86% of Japanese women felt an increase in appetite in one month postpartum and lactating women had stronger appetites than bottle-feeding women. Some participants also felt increased cravings for sweets related to giving up alcohol during lactation.…”

“…Postpartum women are known to experience mental instability due to changes in lifestyle and hormonal balance. In fact, 75% of Japanese women in the first month postpartum reported feeling frustrated [ 23 ]. However, during this period, it is generally considered good to refrain from going out and reduce physical activity for recovery until one month postpartum [ 55 ].…”

“…Thus, the circumstances surrounding dietary behaviors around one month postpartum vary from person to person. In addition, women in this period often experience mastitis and other physical or mental discomforts [ 22 , 23 ]. Thus, women in the first month postpartum are likely to be physically and mentally unstable because they are in the process of recovering from childbirth and adjusting to their new lives.…”