BMC Pregnancy and Childbirth最新文献

Background: Lactation mastitis is a common complication during breastfeeding that can negatively impact maternal well-being and breastfeeding continuation. While the physical manifestations of lactation mastitis have been widely studied, its psychological burden and related contributing factors among affected women have received comparatively less attention. This study aimed to investigate postpartum depressive symptoms and associated factors in women diagnosed with lactation mastitis.

Methods: A cross-sectional survey was conducted among 87 women with lactation mastitis at a tertiary hospital in China. Participants completed a structured questionnaire encompassing five domains: demographics and perinatal history, personal and breast history, psychological and emotional state, breastfeeding practices and nipple condition, and infant characteristics and interaction. Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics, group comparisons, multivariable logistic regression, and sensitivity analyses were used to identify factors associated with elevated EPDS scores.

Results: Overall, 49.4% of participants scored above the clinical threshold for postpartum depressive symptoms on the EPDS. Multivariable logistic regression identified emotional tension during breastfeeding (odds ratio[OR] = 6.807, P = 0.016), younger maternal age (OR = 0.794, P = 0.023), vaginal delivery (OR = 3.382, P = 0.032), and pacifier use (OR = 5.103, P = 0.006) as independent correlates of elevated depressive symptoms. These associations remained robust across sensitivity analyses.

Conclusions: Women with lactation mastitis appear to be at heightened risk of postpartum depressive symptoms and are associated with both maternal and infant-related factors. Early identification of psychological distress, combined with integrated breastfeeding and mental health support, may help address maternal needs and enhance postpartum care.

Background: Labor pain is a major physiological and psychological stressor for women during childbirth. Epidural analgesia is widely recognized as the most effective form of pain relief in labor, yet its utilization varies greatly, and uncertainty remains regarding its determinants and potential impact on maternal and neonatal outcomes. This study aimed to identify factors influencing the use of epidural analgesia and to evaluate its associations with labor progression and postpartum hemorrhage.

Methods: This retrospective cohort included 1035 women who delivered at our hospital between 2020 and 2023. Univariable and multivariable logistic regression analyses were performed to identify independent determinants of epidural analgesia use. A clinical prediction model was developed and compared with eleven machine learning classifiers using receiver operating characteristic analysis. Associations between epidural analgesia and maternal-neonatal outcomes, particularly postpartum hemorrhage, were evaluated.

Results: Younger maternal age, primiparity, and lower pre-delivery fibrinogen levels were independently associated with the use of epidural analgesia. The logistic regression model demonstrated good discrimination (AUC = 0.70, 95% CI: 0.66-0.75), comparable to that of the machine learning models. Among vaginal deliveries, epidural analgesia was associated with longer total, first-stage, and second-stage labor durations (P < 0.001) but did not increase the incidence of postpartum hemorrhage or adverse maternal-neonatal outcomes. Across the entire cohort, higher pre-delivery D-dimer (OR = 1.54, 95% CI: 1.08-2.20, P = 0.017) and fibrinogen (OR = 1.34, 95% CI: 1.07-1.67, P = 0.010) levels were independent risk factors for postpartum hemorrhage, whereas epidural analgesia itself was not.

Conclusions: Maternal age, parity, and coagulation status are key factors influencing the choice of epidural analgesia. Although epidural analgesia prolongs labor, it does not increase postpartum hemorrhage or other adverse outcomes. These findings support the safety of epidural analgesia and highlight the importance of assessing coagulation function to improve individualized labor management and prevent postpartum complications.