Anxiety and stress after birth

Women suffer from anxiety and stress after birth, not only depression

Women can suffer from postnatal anxiety or stress independently of postnatal depression. A study published today in the open access journal BMC Psychiatry concludes that symptoms of anxiety and stress should be assessed in women in the early postnatal period. A scale that measures anxiety and stress independently of depression enabled researchers to detect 61 women who had symptoms of depression, and a further 33 women who had symptoms of anxiety and stress, without depression. There is growing awareness of postnatal depression, however, this study suggests that health practitioners should also be on the lookout for symptoms of anxiety and stress as signs of distress in postnatal women.

The study conducted by Renee Miller and Julie Pallant from Swinburne University of Technology and Lisa Negri from RMIT University, assessed the levels of depression, anxiety and stress in 325 first-time mothers who were 6 weeks to 6 months postnatal. Miller et al. analyzed the results of the widely used Edinburgh Postnatal Depression Scale (EPDS) along with an additional measure, the Depression, Anxiety and Stress Scales (DASS). They found that 33 women (10%) had symptoms of anxiety and stress independent of depression. These women would not have been detected if they had been assessed for depression alone.

According to Miller et al., the focus on depression as the only indicator for emotional distress in postnatal women means that women who have symptoms of anxiety and stress are at risk of not receiving help. Miller et al. conclude that it is important for health practitioners to assess new mothers for broader signs of distress than that of depression alone.

BioMed Central
http://www.brightsurf.com/news

Metabolic disease: new screening method

Metabolic disease too easily missed

Dutch researcher Terry Derks has demonstrated that the metabolic disease MCAD deficiency can be detected at an early stage. At present the disease is only found in half of the expected number of patients.
With the help of a new screening method, all newborns can now be screened. Young children can develop complications due to MCAD deficiency if this is not diagnosed on time. Where early detection fails, it is too late too intervene in a quarter of cases.

A recently developed screening method makes it possible to screen newborns for several metabolic diseases, such as MCAD deficiency. Over the past three years researchers have tested the screening for MCAD deficiency in the north of the Netherlands by means of the heel prick. In this trial project, MCAD deficiency was found to be twice as prevalent than had been predicted. Moreover it was detected four times as frequently as is the case without screening.

Better detection

How prevalent is the condition? The number of patients can be predicted based on the presence of changes in the DNA, so called gene mutations, which can cause the disease. From this the expected number of patients was 1:12,100. And how often was this disease found? Without the heel prick test 1 in 27,400 newborns in the Netherlands were diagnosed with MCAD deficiency. This happens after the patient shows complaints. Therefore the disease was not discovered in more than half of the patients. With the heel prick screening in the northern part of the country the researchers observed the disorder in 1 in 6600 newborns.

North-south gradient

MCAD deficiency was found to be diagnosed more often in the north than in the south of the Netherlands. Interestingly, a north-south gradient for the prevalent MCAD gene mutation is present throughout Europe.

MCAD deficiency

In patients with MCAD deficiency the MCAD enzyme does not function well enough. This enzyme is needed for the production of extra energy. Extra energy is particularly important under certain conditions, for example, during infections, fasting or major exertion. For young children, in particular, having the MCAD deficiency can be dangerous. Normally, they need more energy than adults, and during fever this demand increases. Young children with MCAD deficiency and fever can develop serious complications, probably due to the shortage of energy. As a result of this a simple infection can even become life threatening. About one-quarter of the clinically ascertained patients with MCAD deficiency who are admitted to hospital die before the diagnosis is known. A significant proportion of the children who survive the complications remain permanently disabled.

Heel prick

After an early diagnosis, a child can be helped with a simple treatment. With the new screening method, MCAD deficiency can be investigated for during the heel prick test neonatally. All newborn babies in the Netherlands receive the heel prick. At the recommendation of a Health Council of the Netherlands committee, the heel prick has been extended since 1 January 2007 to include, for example, screening for MCAD deficiency. The committee based its recommendations on a combination of literature research and scientific opinion. For MCAD deficiency, Derks and colleagues provided the scientific evidence that screening newborns is worthwhile.

Netherlands Organisation for Scientific Research
http://www.brightsurf.com/news

Smoking and Pregnancy

Smoking and Pregnancy

Research shows that your baby can be harmed by tobacco smoke.

Some effects of tobacco smoke may include:
• Problems when you are pregnant.
Smoking can increase the risk of miscarriage, stillbirth, premature delivery, or bleeding during your pregnancy.

• Problems when the baby is born.

If you smoke, it is twice as likely that your baby will be small at birth. Low birth weight babies can have health problems.

• Problems as the baby grows.

Sudden infant death syndrome (SIDS) or crib death, happens more often in homes of smokers. Also, babies who are around smokers have more flu, colds, ear infections and breathing problems such as asthma.

We all know quitting smoking is not easy!

Nicotine, the drug found in tobacco, is very addictive. Tobacco smoke contains at least 4,000 other chemicals besides nicotine, and all of these chemicals can be harmful to the health of you and your baby.

If you smoke, try to quit or cut down your smoking as soon as you find out you are pregnant. However, if you quit or cut down any time during your pregnancy, it will help you and your baby. Some women smokers say it is easier to quit or cut down when they were pregnant.

Here are some tips:
• Start slowly. Set a change date, then aim to quit or cut down on that day. Be realistic. Smokers with realistic goals have more success. And, don't give up if you don't reach your goals right away — keep trying.
• Find someone who will help you make changes. Make this person your change or quit “buddy.” The more support you can get from others, the easier it is to make changes.
• Call a counsellor, a community health nurse, or a doctor. They can help pregnant women quit or cut down on their smoking.

What about other people's smoke (second-hand smoke)?

Second-hand smoke can cause health problems for you and your baby, too. If your partner smokes, ask your partner to try to quit or cut down, or to smoke outside. Ask your partner (and anyone else) not to smoke around you. When people smoke around you, leave the room when they are smoking.

Women's Addictions - Research and Education (AWARE), Ontario.

What Is Hypersomnia?

What Is Hypersomnia?
And What Can You Do About It?

In discussions and email lately the word "hypersomnia' keeps cropping up. People want to know what hypersomnia means when used in reference to sleep disorders.

Simply put, hyper means excessive and somnia refers to sleep, so hypersomnia is excessively long or deep sleep. Other symptoms include:
• A gradually onset.
• You can feel the sleepiness coming on.
• It usually starts in the early twenties.
• It has been happening for at least three months.

If you think you are suffering from hypersomnia, ask your doctor about having a sleep study. This will eliminate other disorders such as sleep apnea and narcolepsy. This continual need for sleep will eventually cause a lot of distress and interfere with all areas of your life, from work to home life.

The hypersomniac may sleep up to twelve hours a night, and still need frequent daytime naps.

If you are diagnosed as a victim of recurrent hypersomnia, this is also called Kleine-Levin Syndrome. This syndrome usually affects males more than females and begins some time in the teens.

Idiopathic hypersomnia is much like narcolepsy, except there is no cataplexy, no sleep paralysis, and no rapid eye movement when the victim first falls asleep.

Hypersomnia is one of the symptoms of major depression. In fact, people who are suffering from clinical depression may suffer from either insomnia (inability to fall asleep) or hypersomnia (excessive sleep) nearly every day. Bi-polar patients may also experience hypersomnia during depressive periods.

The cause of hypersomnia is unknown and may vary from victim to victim. Treatment, therefore, consists of changes in behavior, practicing good sleep hygiene and the use of stimulants. Don't nap during the day if you can avoid it. Also avoid things that may interfere with sleep patterns, like alcohol, caffeine near bed time and shift work.

Talk to your doctor. He may be able to prescribe stimulants, a sleep study or other methods of treatment.

http://www.sleepdisorders.about.com

Depression during pregnancy

Depression more common during pregnancy than after childbirth

Depression during pregnancy is more common than postnatal depression, finds a study in this week's BMJ. As mood during pregnancy may affect the unborn child, more efforts need to be directed towards recognising and treating antenatal depression, report the authors.

Over 9,000 pregnant women recorded their mood through pregnancy and after childbirth in a series of questionnaires. Any reported symptoms of depression were measured against a recognised depression scale.
Depression scores were higher during pregnancy than after childbirth, with a peak at 32 weeks of pregnancy and a lowest value 8 months after childbirth. The severity and nature of reported symptoms did not differ before and after childbirth, suggesting that depression is no more likely after childbirth than it is during pregnancy, say the authors.

Although postnatal depression has become a focus of concern, depression during pregnancy has been relatively neglected, say the authors. They call for urgent research into both the consequences for the child and the potential benefits of screening for, and treating, depression during pregnancy. "Offering treatment may be important for both the mother and the future wellbeing of the child and family," they conclude.

British Medical Journal (BMJ)