A 473-mL water drink decreased the vasovagal donor reaction rate in high-school donors by 21 percent, but to varying degrees in different subpopulations.

Background and PrevalenceAcross the US, prevalence studies show that one in five women will experience an episode of major depressive disorder (MDD) during their lifetime [1]. The onset of depressive symptoms is most often seen between 20 to 40 years old, the age range when many women become pregnant [2]. Studies have shown that 10 to 16% of pregnant women fulfill the diagnostic criteria for MDD, and even more women experience subsyndromal depressive symptoms, which are frequently overlooked [3,4]. Because of this correlation with life events, it is very important for healthcare providers to be aware of: 1) the frequency of depression in this population, 2) signs, symptoms and appropriate screening methods, and 3) health risks for the mother and growing fetus if depression is undetected or untreated. A study by Marcus and colleagues in 2003 found that of pregnant women screened in an obstetrics setting who reported significant depressive symptoms, 86% were not receiving any form of treatment. While most women seek some prenatal care over the course of their pregnancy [5], many women do not seek mental health services due to stigma; thus, antenatal visits to an obstetrician or primary care provider may provide an opportunity for screening and intervention for depression in this high risk group. Since management of the depressed, pregnant woman includes care of her growing fetus as well, treatment may be complicated and primary care providers should consider a multidisciplinary approach including the obstetrician, psychiatrist, and pediatrician to provide optimal care [6]. Clinical FeaturesThe Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines the diagnosis of depression via the same criteria for men and women, although research shows some variation in female presentation. MDD diagnosis must include existence of depressed or irritable mood or inability to experience pleasure. In addition, four of the following symptoms must also be present: feelings of guilt, hopelessness, and worthlessness; sleep disturbance (insomnia or hypersomnia); appetite or weight changes; attention or concentration difficulties; decreased energy or unexplainable fatigue; psychomotor agitation or retardation; and in severe cases, thoughts of suicide [7]. Women may present in clinic with more seasonal depression or Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Identification in Primary CarePractitioners caring for women should be aware of personal and epidemiologic factors that place women most at risk for perinatal depression. An important primary risk factor ...

Synopsis Prevalence studies show that one in five women experience an episode of major depressive disorder during their lifetime. The peripartum period constitutes a prime time for symptom exacerbation and relapse of depressive episodes. It is important for health care providers, specifically those in obstetric care, to be aware of (1) the frequency of depression in pregnant and postpartum women; (2) signs, symptoms, and appropriate screening methods; and (3) the health risks for the mother and growing fetus if depression is undetected or untreated. Because management of depressed peripartum women also includes care of a growing fetus or breastfeeding infant, treatment may be complex and requires input from a multidisciplinary team, including an obstetrician, psychiatrist, and pediatrician, to provide optimal care.

Calcium is an essential nutrient during pregnancy and lactation. Calcium contributes to bone development in the fetus and neonate and is considered a critical nutrient. Physiological changes in calcium metabolism occur during pregnancy and lactation. Some women may lose some of their bone density during pregnancy and/or lactation, and then regain it after the cessation of lactation. Implications for childbirth educators include content regarding the topic of calcium in their classes.