Background
Postpartum depression (PPD) is one of the most important mental disorders in recent years. However, the effects of prenatal sleep disorders on the development of PPD among pregnant women have not been elucidated. This review aims to provide a summary of the literature evaluating the relation between sleep disorders during pregnancy and PPD.
Method
A systematic literature search was conducted in PubMed, Web of Science, Scopus, Google Scholar, and Embase up to September 2020. All observational studies (cross‐sectional, case–control, and cohort) and studies that assessed the association between sleep disorders during pregnancy and PPD were included. Total sample of 36,873 women from 13 studies was entered to meta‐analysis. An aggregate effect size estimate (odds ratio) was generated using the comprehensive meta‐analysis software. A random effects model was set a priori. Heterogeneity and publication bias were examined using the standard meta‐analytic approaches.
Result
We found maternal sleep disorder increased odds of PPD (point estimate, 3.300; 95% confidence interval [CI], 2.136–5.098; p < .001; n = 13). However, there was significant heterogeneity (Q, 131.250; df, 12; p < .001; I2, 90.857%). The estimated effect size was significant for all categorical studies. According to meta‐regression, no moderating factor (age and publication year) significantly mediated the estimated effect size.
Conclusion
We found a significant relationship between sleep disturbances during pregnancy and PPD. Women with sleep disorders are at an increased risk of developing PPD, which warrants screening pregnant mothers for sleep disturbances. Also, we found that the increasing age in pregnancy was associated with increased risk of PPD.
Background
The safety of continuing Total Joint Arthroplasty (TJA), as an elective procedure, during the pandemic is controversial. The present study aimed to investigate the incidence of symptomatic COVID-19 and its related risk factors in unvaccinated patients after TJA within one month post-discharge in two large cities of our country.
Methods
The present prospective study included all the patients admitted to three hospitals, located in two high-populated cities of our country from April 1st, 2020, to April 1st, 2021, for elective TJA. Urgent TJA (traumatic fractures) were excluded. The primary outcome was symptomatic COVID-19 within one-month after discharge that was diagnosed using the SARS-CoV-2 RT-PCR test. Afterward, the incidence of the COVID-19 in the study population was compared with the general population to estimate the safety of elective TJA during the pandemic.
Results
From the 1007 patients undergoing TJA, 755 patients met the inclusion criteria. None of the patients was vaccinated against COVID-19. Among them, 18 patients (2.4%) developed symptomatic COVID-19 within one-month after discharge. In the same time interval, the incidence of COVID-19 was 2.2% in the general population of these two cities, which was similar to the incidence reported in the study population. Of the patients who were positive for COVID-19, four patients were hospitalized, and 3 of them were ICU-admitted; however, no mortality was reported.
Conclusion
The TJA will be a safe elective procedure for the patients during the pandemic if the preventive protocols are followed strictly.
It seems that neonates of mothers with well-controlled GDM are still at increased risk of cardiac hypertrophy, subclinical diastolic dysfunction, and impaired left ventricular relaxation. This can be interpreted that focusing only on glycemic control is not enough to prevent cardiac dysfunction.
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