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Background.-Sleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy.

ObjectiveTo characterize sleep habits and parameters among women in mid-to-late pregnancy and to identify disparities associated with poverty, race, and obesity.DesignCross-sectional.SettingLarge multi-site health system in Metro Detroit.ParticipantsA total of 267 pregnant women (27.3% non-Hispanic black; gestational age: 27.99±1.20 weeks) completed online surveys on sleep quality, insomnia symptoms, sleep aid use, signs/symptoms of sleep-disordered breathing, and sociodemographics. Body mass index (BMI) and patient insurance were derived from medical records.ResultsAs high as 76.2% of the women reported global sleep disturbance, 30.6% endorsed snoring, 24.3% sleep <6 hrs/night, and over half screened positive for clinical insomnia. Yet, only 3.4% of the women reported an insomnia diagnosis and 3.0% reported a sleep apnea diagnosis. In unadjusted models, poverty, Medicaid coverage, self-identifying as black, and obesity before and during pregnancy (BMI ≥ 35) were associated with a wide range of sleep problems. However, adjusted models revealed specificity. Poverty was uniquely related to increased insomnia symptoms and trouble sleeping due to bad dreams. Obesity before pregnancy was related to poor sleep quality, snoring, sleep aids, and short sleep. Black women reported shorter sleep duration than white women but differed on no other sleep parameters.ConclusionClinical signs of insomnia and sleep-disordered breathing are common in mid-to-late pregnancy, but most cases go undetected. Problematic sleep disproportionately affects women in poverty, who self-identify as black, and who are obese before pregnancy. Poverty-related sleep issues are linked to insomnia, obesity-related disparities center on sleep-related breathing and medication use, and racial disparities relate to short sleep.

Vitamin D levels of pregnant women and their neonates tend to be related; however, it is unknown whether there are any subgroups in which they are not related. 25-Hydroxyvitamin D [25(OH)D] was measured in prenatal maternal and child cord blood samples of participants (n = 241 pairs) in a birth cohort. Spearman correlations were examined within subgroups defined by prenatal and delivery factors. Cord blood as a percentage of prenatal 25(OH)D level was calculated and characteristics compared between those who did and did not have ≥25% and ≥50% of the maternal level and those who did and did not have a detectable 25(OH)D level. The correlation among Black children was lower than in White children. When the maternal 25(OH)D level was <15 ng/mL, the overall correlation was r = 0.16. Most children had a 25(OH)D cord blood level less than half of their mother's; 15.4% had a level that was <25% of their mother's. Winter birth and maternal level were associated with the level being less than 25%. Children with undetectable levels were more likely to be Black and less likely to be firstborn. These data suggest mothers may reduce their contribution to the fetus's 25(OH)D supply once their own level becomes low.

These findings about perceptions, beliefs, and attitudes of women having undergone hysterectomy could support health care providers deliver patient-centered care. These results informed data collection for a prospective longitudinal cohort study that is now underway. The data suggest a need for increased education and empowerment in the decision making process, while expanding on information given for post-operative expectations and somatic changes that occur post-hysterectomy.

A retrospective cohort of 100 robotic-assisted laparoscopic myomectomy (RM) patients and 48 laparotomic myomectomy (LM) patients at Henry Ford Hospital in Detroit, MI, USA was examined to compare surgical outcomes of RM with LM. Details of age, race, body mass index (BMI), procedure duration, estimated blood loss (EBL), length of stay (LOS), diameter of the largest leiomyoma and number of leiomyomata removed were collected. Procedure duration was significantly longer among RM patients (median: 194 min vs. 127.5 min; Wilcoxon rank sum (WRS) P < 0.001). EBL and LOS were both significantly greater among LM patients (EBL medians 200 vs. 100 ml, WRS P < 0.001; LOS medians 3 vs. 1, WRS P < 0.01). Among the RM patients, 39.4% had a LOS of at least 2 days compared to 89.4% among LM patients. Leiomyomata characteristics did not affect the observed associations. RM could enable widespread use of a minimally invasive approach for leiomyoma treatment.

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Objective: To determine how self-compassion and empathy might influence the degree of burnout, secondary traumatic stress and compassion satisfaction among medical students and residents. Methods: Cross-sectional survey of medical students and select residency programs at Henry Ford Hospital in Detroit, Michigan. Respondents completed the Professional Quality of Life Scale (burnout, secondary traumatic stress and compassion satisfaction), Neff's Self-Compassion Scale, and the empathic concern and personal distress subscales of the Interpersonal Reactivity Index. Results: The response rate was 28.6%. 23.9% and 27.3% of medical trainees reported high levels of burnout and secondary traumatic stress, respectively. Females reported greater empathy but lower self-compassion than males. Greater concern for others and oneself and lower personal distress predicted greater pleasure derived from professional work. Less concern for others and lower concern for oneself predicted greater burnout. Conclusions: Compassion for oneself and for others within their care appears to ameliorate burnout and can increase professional satisfaction. Initiatives to foster empathy and self-compassion may enhance individual well-being.