Startseite Assessing high-risk perinatal complications as risk factors for postpartum mood disorders
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Assessing high-risk perinatal complications as risk factors for postpartum mood disorders

  • Tatiana Doroskin ORCID logo EMAIL logo , Sidney Broome , Carly Kinzer , Madison Dallas , Mehrsa Razavi , Melissa Bright und Dikea Roussos-Ross
Veröffentlicht/Copyright: 14. April 2025
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Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 53 Heft 5

Abstract

Objectives

Postpartum mood disorders affect approximately 20 % of postpartum women. This study examines the association between postpartum mood disorders and preeclampsia with severe features (SPE), postpartum hemorrhage (PPH), very/extremely preterm delivery (EPTD), and fetal congenital malformations (FCM).

Methods

A retrospective chart review was conducted at a large southeastern quaternary academic hospital using ICD-10 codes for the four high-risk perinatal complications. Medical records included 3,652 cases and 750 normal patient comparisons (NPC). Inclusion criteria: 1) prenatal visit at the institution, 2) live delivery at the institution, 3) postpartum visit at the institution, and 4) completed Edinburgh Postnatal Depression Scale (EPDS) at postpartum visit. EPDS scores≥12 and EPDS-3A scores≥5 were considered positive for depression and anxiety symptoms, respectively.

Results

Five cohorts were analyzed [NPC (n=200), SPE (n=150), PPH (n=153), EPTD (n=102), and FCM (n=200)]. Independent sample t-tests revealed significant differences in mean EPDS scores between NPC and EPTD (p<0.001) and FCM (p=0.014) and in mean EPDS-3A scores between NPC and EPTD (p<0.001) and PPH (p=0.011).

Conclusions

EPTD, FCM, and PPH are diagnoses associated with elevated EPDS and/or EPDS-3A scores. Increased mood surveillance in patients with these complications is warranted. Understanding the association of these conditions with increased depression and anxiety symptoms will allow for earlier identification and treatment of postpartum mood disorders.

Keywords: fetal congenital malformations; postpartum anxiety; postpartum depression; postpartum hemorrhage; preterm delivery; severe pre-eclampsia

Introduction

Postpartum mood disorders are very common, occurring in approximately 20 % of women [1], 2]. Postpartum depression (PPD) has estimates of prevalence ranging from 13-19 % [3], 4] and differs from depression unrelated to childbirth in that anxiety symptoms are more often present in PPD [5], [6], [7]. Studies suggest the relative prevalence of postpartum anxiety (PPA) is closer to 20–25 % [8], 9]; however, the overall quantity of studies is more limited than those of PPD. Previous research has documented a strong relationship between PPD and PPA [10], 11] and has determined multiple risk factors for both diagnoses, including violence and abuse [12], [13], [14], immigration status [15], 16], gestational diabetes [17], cesarean section [18], 19], and more [20]. However, there is limited research on particular high-risk pregnancy-related diagnoses in relation to PPD or PPA.

Given the lack of data, our study focuses on high-risk pregnancy complications and their relations to mental health. The following high-risk complications were investigated: pre-eclampsia with severe features (SPE), postpartum hemorrhage (PPH), very/extremely preterm delivery (EPTD) and fetal congenital malformations (FCM).

While the physical repercussions of PPH are understood, there is minimal research regarding associated psychiatric sequelae with PPH [21], [22], [23], [24]. Further, there is mixed data on the pregnant person’s psychiatric wellbeing in the setting of SPE [25], [26], [27], [28], FCM [29], [30], [31], and EPTD [32], [33], [34], [35]. Whereas some studies indicate a higher risk of mental health issues in those with complications, the majority indicate the lack thereof, and the need for further studies. The objective of this retrospective study was to analyze these four disorders to determine whether an association between a high-risk perinatal diagnosis and elevated EPDS scores is seen. The elevated EPDS score and EPDS-3A score are used as markers of increased risk of PPD and PPA, respectively. In this context, our research hypothesis predicts an increased incidence of elevated EPDS and EPDS-3A scores in patients with SPE, PPH, EPTD and FCM.

Materials and methods

Sample

After Institutional Review Board approval, a retrospective chart review of subjects who delivered at a large southeastern quaternary care academic hospital between 1/1/2015 and 4/1/2022 was conducted. A total of 3,652 subjects were identified from International Classification of Disease-10 codes (ICD-10) related to high-risk perinatal complications. Figure 1 demonstrates the flowchart of how the diagnosis cohorts were established. Medical record numbers with overlapping perinatal ICD-10 codes were excluded. Using a random number generator, trained chart reviewers performed random queries for each diagnosis cohort. A total of 750 MRNs without the aforementioned ICD-10 codes were obtained and randomly queried, forming a normal patient comparison group (NPC). This NPC sample can be seen in Figure 2. Extracted data was stored and managed in Research Electronic Data Capture (REDCap) [36], 37].

Figure 1: Diagnosis cohorts flow diagram. The Figure reveals how the diagnosis cohorts were established. Exclusion criteria were determined to isolate the specific complication as the likely sole risk factor for postpartum psychiatric disorders. In total, 150 SPE, 153 PPH, 102 PTD and 200 FCM cohort subjects qualified.
Figure 1:

Diagnosis cohorts flow diagram. The Figure reveals how the diagnosis cohorts were established. Exclusion criteria were determined to isolate the specific complication as the likely sole risk factor for postpartum psychiatric disorders. In total, 150 SPE, 153 PPH, 102 PTD and 200 FCM cohort subjects qualified.

Figure 2: Normal patient comparison (NPC) cohort flow Diagram.  Figure 2 reveals how the NPC cohort was established. In total, 200 NPC subjects qualified.
Figure 2:

Normal patient comparison (NPC) cohort flow Diagram.  Figure 2 reveals how the NPC cohort was established. In total, 200 NPC subjects qualified.

Inclusion criteria for both NPC and diagnosis cohorts required the subject to have at least one prenatal visit, delivery, and at least one postpartum visit within the quaternary care institution, and a completed postpartum Edinburgh Postnatal Depression Scale (EPDS). In addition to the above, the NPC group included those who had no current or prior history of significant perinatal complications including those investigated in this study. Subjects in the SPE, PPH, EPTD and FCM diagnosis cohorts were only permitted to have one of the specific high-risk complications in order to be included. For instance, a subject who delivered a preterm baby at 30 weeks’ gestation could not have concurrently been diagnosed with SPE, PPH or FCM.

Further inclusion criteria for the severe pre-eclampsia diagnosis cohort required blood pressures of at least 160/110, along with uteroplacental dysfunction and signs of maternal end-organ dysfunction (liver, renal, hematological, neurological involvement).

Additionally, inclusion criteria for the postpartum hemorrhage diagnosis cohort required mothers who delivered with cumulative blood loss greater than or equal to 1,000 mL with signs or symptoms of hypovolemia or shock. It was noted whether the mother received a blood transfusion.

Inclusion criteria for the very/extremely preterm delivery diagnosis cohort required mothers who delivered between 22 weeks and 0 days to 32 weeks and 0 days. Infants delivered prior to 32 weeks were considered very premature and infants delivered prior to 28 weeks were considered extremely premature. Thereby, the NPC group included those who delivered at/after 32 weeks gestation.

Finally, inclusion criteria for the fetal congenital malformation diagnosis cohort required a true malformation occurring between 3 and 8 weeks gestation. The categories are listed as follows, with relevant examples of each: cardiac (ventricular septal defect, Tetralogy of Fallot, hypoplastic left heart), facial (cleft lip, cleft palate), gastrointestinal (gastroschisis, omphalocele), renal (uni/bilateral renal agenesis, multicystic dysplastic kidneys), neurological (Dandy Walker malformation, neural tube defects, Chiari I/II), pulmonary (congenital pulmonary airway malformations), and multiple systems (trisomies, neonate with both myelomeningocele and a cleft lip, etc.). These categories are further outlined in Table 1. Those with diagnoses of disruptions or deformations were not included.

Table 1:

Fetal congenital malformation Categories.

Malformation categories Number of FCM subjects
Cardiac 79
Facial 7
Gastrointestinal 6
Renal 7
Nervous system 42
Multisystem 59

Exclusion criteria were determined to isolate the specific complication as the likely sole risk factor for postpartum psychiatric disorders. In total, 200 NPC subjects qualified (Figure 2) and were compared to 150 SPE, 153 PPH, 102 EPTD and 200 FCM qualified cohort subjects (Figure 1).

Measures

Postpartum depression and anxiety

ACOG recommends screening for perinatal mood disorders with a validated screening tool. The Edinburgh Postnatal Depression Scale (EPDS) was developed to detect symptoms of postpartum depression across diverse samples [38], [39], [40]. EPDS is a widely-used survey consisting of 10 questions, each with four response options. The total score can range from 0-30, with higher scores indicating greater mood disorder symptomatology. The cutoff value for a positive EPDS score has varied across studies. A systematic review of seven studies with over 1,000 postpartum individuals found that the optimal EPDS threshold range was ≥9 to ≥13, yielding a pooled sensitivity and specificity of 94.4 and 90.8 %, respectively [39]. Another systematic review consisting of 11 studies with over 3,000 postpartum individuals found sensitivities and specificities ranging from 80-90 % using a cutoff score of 12 [40]. For this study, EPDS was obtained at the 6–8 week postpartum clinic visit with an EPDS score of ≥12 is considered positive for risk of postpartum depression.

Further, EPDS-3A is a subscale of EPDS consisting of questions 3, 4, and 5, which focuses on postpartum anxiety (PPA). The risk for PPA is calculated by totaling answers from question 3 (I have blamed myself unnecessarily when things went wrong), 4 (I have been anxious or worried for no good reason), and 5 (I have felt scared or panicky for no good reason). For this study, EPDS was obtained at the 6–8 week postpartum clinic visit with an EPDS-3A score of ≥5 is considered positive for risk of postpartum anxiety.

Covariates

History of psychiatric diagnosis, history of perinatal complications, and prenatal onset of psychiatric symptoms, and demographic characteristics (race/ethnicity, insurance status) were tested for their association with predictor and outcomes and included as covariates when appropriate. This information was obtained via the patient’s electronic medical record.

Analysis plan

We conducted two, one-way analyses of variance (ANOVA) to examine group differences in EPDS and EPDS-3A scores. We then conducted t-tests comparing each diagnosis group to NPC group on EPDS and EPDS-3A scores. Alpha was set at<0.05 to define statistical significance. All analyses were performed using R Statistical Software (v4.1.2; R Core Team 2021).

Results

The demographics of the NPC and diagnosis cohort groups are shown in Table 2.

Table 2:

Patient Demographics.

Variable Normal patient comparison Severe pre-eclampsia Postpartum hemorrhage Very/extremely preterm delivery Congenital malformation
Age, years 29 ± 5.73 29 ± 6.27 28 ± 5.79 27 ± 5.91 28 ± 5.51
Race & ethnicity Normal patient comparison Severe pre-eclampsia Postpartum hemorrhage Very/extremely preterm delivery Congenital malformation
White 54.5 % 47.3 % 48.7 % 43.1 % 61.0 %
Black 22.0 % 47.3 % 29.4 % 48.0 % 27.5 %
Asian 9.5 % 0.0 % 8.5 % 2.0 % 1.5 %
Other 13.5 % 5.3 % 13.7 % 6.9 % 10.0 %
Hispanic or Latino 13.5 % 9.3 % 16.3 % 9.8 % 7.0 %
Insurance status Normal patient comparison Severe pre-eclampsia Postpartum hemorrhage Very/extremely preterm delivery Congenital malformation
Private 55.5 % 45.3 % 57.5 % 36.3 % 46.0 %
Public 37.5 % 54.0 % 35.3 % 50.0 % 47.5 %
Uninsured 5.0 % 0.7 % 5.2 % 3.9 % 6.5 %
Marital status a Normal patient comparison Severe pre-eclampsia Postpartum hemorrhage Very/extremely preterm delivery Congenital malformation
Single 40.5 % 63.3 % 47.7 % 53.9 % 55.0 %
Married 55.5 % 34.0 % 48.4 % 40.2 % 41.5 %
Gestational age, weeks Normal patient comparison Severe pre-eclampsia Postpartum hemorrhage Very/extremely preterm delivery Congenital malformation
Mean 39 28
Min 35 22
Max 42 32

  1. aUndocumented marital status for 3.5 and 2.7 % of congenital malformation and severe pre-eclampsia subjects respectively.

Depression

We conducted a one-way ANCOVAs examining differences in mean EPDS scores based on the diagnosis group, controlling for the covariates of patient race/ethnicity, insurance status, history of psychiatric diagnosis, history of prior complications, and prenatal onset of psychiatric symptoms. Although the overall model for EPDS was significant (F[7,370]=3.42, p=0.002; Adj. R2 0.06;), there were no differences detected among diagnosis groups, p=0.412.

Power analysis revealed the sample was underpowered to detect group differences (cohen’s f=0.05); however, the sample size needed to achieve adequate power was impractical and likely would reveal statistically but not practically meaningful differences. Thus, the study findings are not likely to change with additional sample.

Independent samples t-tests comparing EPDS scores of the NPC group to each diagnosis group revealed no differences between NPC and SPE or NPC and PPH. However, there were differences between NPC and EPTD (p<0.001) and FCM (p=0.014). The results of these independent samples t-tests are outlined in Table 3.

Table 3:

Mean Edinburgh Postnatal Depression Scale (EPDS) scores by diagnosis group, T-tests comparisons of EPDS Scores for Normal patient comparison group and all other groups.

Perinatal complication EPDS score Mean (standard deviation) p-Value
Normal patient comparison 4.78 (4.97)
Severe pre-eclampsia 5.01 (5.15) 0.693
Postpartum hemorrhage 5.47 (4.95) 0.225
Very/extremely preterm delivery 7.82 (6.30) 0.000
Congenital malformation 6.23 (5.99) 0.014

Anxiety

We conducted a one-way ANCOVAs examining differences in mean EPDS-3A scores based on the diagnosis group, controlling for patient race/ethnicity, insurance status, history of psychiatric diagnosis, history of prior complications, and prenatal onset of psychiatric symptoms). Although the overall model for EPDS was significant (F[7,374]=4.57, p<0.001; Adj. R2 0.08;), there were no differences detected among diagnosis groups, p=0.509.

Power analysis revealed the sample was underpowered to detect group differences (cohen’s f=0.05); however, the sample size needed to achieve adequate power was impractical and likely would reveal statistically but not practically meaningful differences. Thus, the study findings are not likely to change with additional sample.

Independent samples t-tests comparing EPDS-3A scores of the NPC group to each diagnosis group revealed no differences between NPC and SPE or NPC and congenital malformation, p>0.05. However, there were differences between NPC and EPTD (p<0.001) and PPH (p=0.011). PPH EPDS-3A scores did not differ based on transfusion status, p>0.05. The results of these independent samples t-tests are outlined in Table 4 and Table 5.

Table 4:

Mean Edinburgh Postnatal Depression Scale (EPDS) scores by diagnosis group, T-tests comparisons of EPDS-3A scores for Normal patient comparison group and all other groups.

Perinatal complication EPDS score Mean (standard deviation) p-Value
Normal patient comparison 2.26 (2.26)
Severe pre-eclampsia 2.42 (2.21) 0.578
Postpartum hemorrhage 3.01 (2.25) 0.011
Very/extremely preterm delivery 3.53 (2.47) 0.000
Congenital malformation 2.64 (2.41) 0.163
Table 5:

T-test comparison of Edinburgh Postnatal Depression Scale (EPDS) and EPDS-3A scores for women with postpartum hemorrhage (PPH) with blood transfusion compared to women with PPH without blood transfusion.

Perinatal complication EPDS score Mean EPDS-3A score Mean p-Value
PPH with blood transfusion 5.484 3.096 0.4513
PPH without blood transfusion 6.298 2.974 0.7987

Discussion

Principal findings

After comparing the mean EPDS scores of each diagnosis cohort to subjects without high-risk complications, only EPTD and FCM had significantly higher EPDS scores. Patients with EPTD or FCM reported a higher number of postpartum depressive symptoms, indicating that these complications independently act as risk factors for elevated EPDS and risk of PPD. Interestingly, the diagnoses that were associated with increased EPDS and increased risk of PPD were diagnoses that specifically affect the fetus/neonate (EPTD, FCM). Conversely, diagnoses related to the health of the mother, SPE and PPH, did not show increased EPDS scores compared to the NPC group. This interesting finding may suggest that the mother’s mental wellbeing is related to the neonate’s health, rather than her own health, and warrants further investigation.

Regarding the EPDS-3A scores, only EPTD and PPH had significantly higher EPDS-3A scores. Patients with EPTD or PPH reported a higher number of postpartum anxiety symptoms, indicating that these complications independently act as risk factors for elevated EPDS-3A, which is a marker for postpartum anxiety.

There was no difference in EPDS or EPDS-3A scores for women with PPH who had a blood transfusion compared to women with PPH who did not have a blood transfusion.

Results in context of what is known

Finding positive associations between EPTD or FCM with higher postpartum EPDS scores aligns with other literature data. Studies have shown associations between elevated depression and anxiety symptoms and FCM [30] and EPTD [41], 42]. However, other investigators studying EPTD and PPD suggests no association [32] or that more prospective population-based research is needed [33].

In contrast, there is more literature that conflicts with the null findings of SPE and PPH. Several studies found positive associations between pre-eclampsia and PPD [24], [25], [26], but some had findings supporting no association [27], 28] similar to this study. Literature pertaining to a PPH and PPD association likewise provides contrary conclusions. A study finding that PPH may act as a risk factor for postpartum depressive symptoms [21] conflicts with another study reporting that PPH subjects were less likely to have PPD [22]. A systematic review on PPH and PPD found no clear association and more research is necessary [23].

A prominent reason for these differences in findings is the different research designs and methodologies. This study is the first investigative research independently examining these four specific perinatal complications as PPD risk factors. None of the referenced studies excluded subjects with co-occurring high-risk perinatal complications. Other contributing factors to the conflicting findings may be due to differences in definitions of perinatal disorders, postpartum time frames to collect data, modes of outcome measurements, and interpretations of a positive EPDS score (when used in research design).

Clinical implications

There were significant differences in mean EPDS and EPDS-3A scores between the four diagnosis groups and the NPC group studied, with EPTD leading to the highest risk of PPD and PPA symptoms. Since approximately 75 % of NICU admissions are related to prematurity, parents whose babies are admitted to the NICU may experience increased levels of distress, leading to higher risk of developing PPD/PPA [43].

The results of this study identifies the need for earlier and more vigilant screening of perinatal mood disorders, specifically depression and anxiety. Evaluating mood throughout pregnancy with validated screening instruments such as the EPDS, PHQ-9, GAD-7 are helpful in assessing patients’ mental health during the pregnancy and postpartum period [44]. Physicians can proactively discuss symptoms with patients and their partners regarding symptom recognition, thereby promoting early intervention. If patients attribute their depressive and anxiety symptoms to the stress of parenthood, they may ignore manifestations of psychiatric sequelae they are experiencing due to one of the complications discussed in the study. Connecting parents with educational resources such as early intervention or transitional programs, has produced promising, lasting results of decreased depressive symptoms for patients whose preterm infants were hospitalized [45], 46]. Not only does anxiety affect the mental health of the pregnant person, but it also has negative consequences for the development of neonates. When patients are identified as having symptoms of depression or anxiety, they can be offered psychotherapy or psychopharmacologic management (or a combination of both). Cognitive behavioral therapy and interpersonal therapy are two modalities that are evidenced based treatment options for pregnant and postpartum individuals [47].

Research implications

Women were followed for a period of 6–8 weeks postpartum, but depressive and anxiety symptoms can manifest anytime within the 12-month postpartum period. Subsequent investigations should assess women up to 12 months postpartum to assess PPD and PPA diagnoses, as this study may have underestimated that number due to six to 8-week postpartum follow-up [48].

Strengths and limitations

By independently examining each high-risk perinatal complication as a PPD/PPA risk factor and using a NPC cohort, our study is strengthened by eliminating possible confounders, thus increasing internal validity. However, with this strength comes limitations. Patients with multiple diagnoses may be at higher risk of PPD or PPA. Multiple diagnoses could show a synergistic effect on EPDS scores, but this research design makes such evaluation impossible. With that, severe preeclampsia is underrepresented in this cohort as no cases with concurrent preeclampsia and very/extremely preterm delivery (<32 weeks) were included. This relationship between the two cohorts, and the apparent absence of association with PPA or PPD with severe pre-eclampsia, requires further investigation in future studies, as it is possible that mothers with overlapping severe pre-eclampsia and severe prematurity may have had positive EPDS. An overarching limitation of this study is the overall decrease in external validity as subjects who experienced multiple high-risk complications were excluded. Small sample sizes for the EPTD (n=102) cohort also lowered statistical power and decreased external validity.

There is a need for studies looking into dose-dependent relationships between either multiple risk factors or cases within each cohort with greater risk. For example, a major or multi-organ congenital anomaly vs. single or isolated malformation.

Additionally, using a time frame of 6–8 weeks postpartum to assess EPDS may have resulted in underestimated PPD and PPA incidence [48]. Studies using longer postpartum time frames to assess for PPD and PPA symptoms could explain finding discrepancies amongst literature. The infant’s wellbeing following the liveborn delivery was not evaluated during the postpartum visit, potentially confounding the incidence of PPD and PPA.

Finally, as this study was a retroactive chart review with charts identified via ICD diagnosis code, if the physician did not code correctly, there is potential for some applicable, but missing charts from our sample. Additionally, this study analyzed subjects via specific ICD diagnosis codes and not the association of maternal morbidity, as well as fetal morbidity and mortality. These factors may contribute to psychiatric disorders but may not necessarily follow the lines of a specific obstetric or ICD diagnosis. There is a need for studies looking into the morbidity and mortality of both mother and fetus.

Conclusions

This retrospective analysis examined four high-risk perinatal conditions (SPE, PPH, EPTD and FCM) to determine if these diagnoses serve as risk factors for elevated EPDS scores serving as a marker for postpartum depression and anxiety. Our results revealed that both very/extremely preterm delivery and fetal congenital malformations were associated with a significantly increased incidence of elevated EPDS which increases the risk of PPD; additionally, very/extremely preterm delivery and postpartum hemorrhage were associated with an increased incidence of elevated EPDS-3A which increases the risk of PPA. Conversely, there was no significantly increased incidence of elevated EPDS among those with PPH or SPE, and no increased incidence of elevated EPDS-3A among those with SPE and FCM. While clinicians should carefully screen and monitor all postpartum patients for depression and anxiety symptoms, diligence may be warranted for those who delivered very/extremely preterm infants or infants with congenital malformations, and those with postpartum hemorrhage.

Corresponding author: Tatiana Doroskin, BA, Medical Student, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, 32610-0294, FL, USA, E-mail:

Funding source: University of Florida College of Medicine Medical Student Research Program

Award Identifier / Grant number: No associated grant or award number.

Acknowledgments

We would like to thank Tiffany Lowtan, MD at Orlando Health, who was responsible for the creation of the REDCap templates for each diagnosis group.

  1. Research ethics: Institutional Review Board Approval Number: #IRB202001244. Date ethical approval was granted=6/6/2022.

  2. Informed consent: Not applicable.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. TD (first author): Conceptualization, Validation, Investigation, Resources, Data Curation, Writing – Original Draft, Writing – Review & Editing, Visualization, Project administration. SB (second author): Conceptualization, Validation, Investigation, Resources, Data Curation, Writing – Original Draft, Writing – Review & Editing, Visualization, Project administration. CK (third author): Conceptualization, Validation, Investigation, Resources, Data Curation, Writing – Original Draft. MD (fourth author): Conceptualization, Validation, Investigation, Resources, Data Curation, Writing – Original Draft. MR (fifth author): Conceptualization, Validation, Investigation, Resources, Data Curation, Writing – Original Draft. MB (sixth author): Methodology, Software, Formal Analysis, Writing – Review & Editing. DRR (seventh author): Conceptualization, Methodology, Software, Writing – Review & Editing, Supervision, Project administration.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: This study was supported by the Medical Student Research Program (MSRP) funded by a large southeastern academic hospital; this sponsor did not have a role in study design, data collection or analysis, or decision to submit this article. There is no grant or fund number associated with MSRP.

  7. Data availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2024-11-19
Accepted: 2025-03-13
Published Online: 2025-04-14
Published in Print: 2025-06-26

© 2025 the author(s), published by De Gruyter, Berlin/Boston

This work is licensed under the Creative Commons Attribution 4.0 International License.

Artikel in diesem Heft

  1. Frontmatter
  2. Reviews
  3. Pharmacologic thromboprophylaxis following cesarean delivery-what is the evidence? A critical reappraisal
  4. Fetal cardiac diagnostics in Indonesia: a study of screening and echocardiography
  5. Original Articles – Obstetrics
  6. Comparative analysis of antidiuretic effects of oxytocin and carbetocin in postpartum hemorrhage prophylaxis: a retrospective cohort study
  7. Severe thrombocytopenia in pregnancy: a cross-sectional analysis of perinatal and neonatal outcomes across different platelet count categories
  8. Association of urinary misfolded protein quantification with preeclampsia and adverse pregnancy outcomes: a retrospective case study
  9. Differentially expressed genes in the placentas with pre-eclampsia and fetal growth restriction using RNA sequencing and verification
  10. Upregulation of microRNA-3687 promotes gestational diabetes mellitus by inhibiting follistatin-like 3
  11. Placental elasticity in trisomy 21: prenatal assessment with shear-wave elastography
  12. Penicillin allergies and selection of intrapartum antibiotic prophylaxis against group B Streptococcus at a safety-net institution
  13. Assessing high-risk perinatal complications as risk factors for postpartum mood disorders
  14. Original Articles – Fetus
  15. Assessment of fetal thymus size in pregnancies of underweight women
  16. Normal fetal echocardiography ratios - a multicenter cross-sectional retrospective study
  17. Original Articles – Neonates
  18. Evaluation of the relationship of fetal lung elastography values with the development of postpartum respiratory distress in late preterm labor cases
  19. Short Communication
  20. Radiographic thoracic area in newborn infants with Down’s syndrome
  21. Letter to the Editor
  22. Teaching prospective parents basic newborn life support (BNLS) for unplanned out-of-hospital births
https://doi.org/10.1515/jpm-2024-0556
Schlagwörter für diesen Artikel
fetal congenital malformations; postpartum anxiety; postpartum depression; postpartum hemorrhage; preterm delivery; severe pre-eclampsia
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Frontmatter
  2. Reviews
  3. Pharmacologic thromboprophylaxis following cesarean delivery-what is the evidence? A critical reappraisal
  4. Fetal cardiac diagnostics in Indonesia: a study of screening and echocardiography
  5. Original Articles – Obstetrics
  6. Comparative analysis of antidiuretic effects of oxytocin and carbetocin in postpartum hemorrhage prophylaxis: a retrospective cohort study
  7. Severe thrombocytopenia in pregnancy: a cross-sectional analysis of perinatal and neonatal outcomes across different platelet count categories
  8. Association of urinary misfolded protein quantification with preeclampsia and adverse pregnancy outcomes: a retrospective case study
  9. Differentially expressed genes in the placentas with pre-eclampsia and fetal growth restriction using RNA sequencing and verification
  10. Upregulation of microRNA-3687 promotes gestational diabetes mellitus by inhibiting follistatin-like 3
  11. Placental elasticity in trisomy 21: prenatal assessment with shear-wave elastography
  12. Penicillin allergies and selection of intrapartum antibiotic prophylaxis against group B Streptococcus at a safety-net institution
  13. Assessing high-risk perinatal complications as risk factors for postpartum mood disorders
  14. Original Articles – Fetus
  15. Assessment of fetal thymus size in pregnancies of underweight women
  16. Normal fetal echocardiography ratios - a multicenter cross-sectional retrospective study
  17. Original Articles – Neonates
  18. Evaluation of the relationship of fetal lung elastography values with the development of postpartum respiratory distress in late preterm labor cases
  19. Short Communication
  20. Radiographic thoracic area in newborn infants with Down’s syndrome
  21. Letter to the Editor
  22. Teaching prospective parents basic newborn life support (BNLS) for unplanned out-of-hospital births
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