Postnatal development of rat retina:a continuous observation and comparison between the organotypic retinal explant model and in vivo development

The organotypic retinal explant culture has been established for more than a decade and offers a range of unique advantages compared with in vivo experiments and cell cultures.However,the lack of systematic and continuous comparison between in vivo retinal development and the organotypic retinal explant culture makes this model controversial in postnatal retinal development studies.Thus,we aimed to verify the feasibility of using this model for postnatal retinal development studies by comparing it with the in vivo retina.In this study,we showed that postnatal retinal explants undergo normal development,and exhibit a consistent structure and timeline with retinas in vivo.Initially,we used SOX2 and PAX6 immunostaining to identify retinal progenitor cells.We then examined cell proliferation and migration by immunostaining with Ki-67 and doublecortin,respectively.Ki-67-and doublecortin-positive cells decreased in both in vivo and explants during postnatal retinogenesis,and exhibited a high degree of similarity in abundance and distribution between groups.Additionally,we used Ceh-10 homeodomain-containing homolog,glutamate-ammonia ligase(glutamine synthetase),neuronal nuclei,and ionized calcium-binding adapter molecule 1 immunostaining to examine the emergence of bipolar cells,Müller glia,mature neurons,and microglia,respectively.The timing and spatial patterns of the emergence of these cell types were remarkably consistent between in vivo and explant retinas.Our study showed that the organotypic retinal explant culture model had a high degree of consistency with the progression of in vivo early postnatal retina development.The findings confirm the accuracy and credibility of this model and support its use for long-term,systematic,and continuous observation.

Comparison of Soleus Muscle Fibers in Rats and Rabbits at Different Stages of Postnatal Development

In the present study,the effects of postnatal development on the number and distribution of skeletal muscle fibers of different types in hind leg of rat and rabbit were studied.The soleus muscles of rats aged 2 days,2,4,6,8,and 10 weeks (body weight 10,32,95,190,280,and 320 g),and rabbits aged 2 days,2,4,8,12,16,20,and 24 weeks (body weight 100,220,400,750,1 200,1 600,2 100,and 2 500 g) were stained with succinic dehydrogenase.With an image analysis system,the X-Y coordinates of fibers were used to analyze the growth-related changes.The results of present study showed that three types of fibers were found in the soleus muscles of rat and rabbit,i.e.,type Ⅰ (slow oxidative),ⅡX (fast oxidative),and ⅡA (fast oxidative glycolytic).The type Ⅰ fibers were present throughout the muscle that had a uniform distribution and tended to increase in number with aging.Type ⅡX fibers were scattered throughout the muscle and decreased markedly in number with aging.Type ⅡA fibers were located at the central and deep regions,and showed a little or no change in number and distribution with aging.While be of age,type ⅡA and ⅡX fibers became restricted to the superficial region.No type ⅡB fibers were detected.Type ⅡA fibers had the largest diameter,type Ⅰ intermediate and type ⅡX the smallest.Mean cross-sectional area of each type fibers of rabbits was larger than that of rats.The present results indicate that the number and distribution of muscle fibers of different types in hind limb of rat and rabbit change with the process of postnatal growth.

Postnatal calpeptin treatment causes hippocampal neurodevelopmental defects in neonatal rats

Our previous studies showed that the early use of calpain inhibitors reduces calpain activity in multiple brain regions, and that postnatal treatment with calpeptin may lead to cerebellar motor dysfunction. However, it remains unclear whether postnatal calpeptin application affects hippocampus-related behaviors. In this study, Sprague-Dawley rats were purchased from the Animal Center of Anhui Medical University of China. For the experiments in the adult stage, rats were intraperitoneally injected with calpeptin, 2 mg/kg, once a day, on postnatal days 7–14. Then on postnatal day 60, the Morris water maze test was used to evaluate spatial learning and memory abilities. The open field test was carried out to assess anxiety-like activities. Phalloidin staining was performed to observe synaptic morphology in the hippocampus. Immunohistochemistry was used to count the number of NeuN-positive cells in the hippocampal CA1 region. DiI was applied to label dendritic spines. Calpeptin administration impaired spatial memory, caused anxiety-like behavior in adulthood, reduced the number and area of apical dendritic spines, and decreased actin polymerization in the hippocampus, but did not affect the number of NeuN-positive cells in the hippocampal CA1 region. For the neonatal experiments, neonatal rats were intraperitoneally injected with calpeptin, 2 mg/kg, on postnatal days 7 and 8. Western blot assay was performed to analyze the protein levels of Akt, Erk, p-Akt, p-Erk1/2, Erk1/2, SCOP, PTEN, mTOR, p-mTOR, CREB and p-CREB in the hippocampus. SCOP expression was increased, and the phosphorylation levels of Akt, mTOR and CREB were reduced in the hippocampus. These findings show that calpeptin administration after birth affects synaptic development in neonatal rats by inhibiting the Akt/mTOR signaling pathway, thereby perturbing hippocampal function. Therefore, calpeptin administration after birth is a risk factor for neurodevelopmental defects.

Spatial and temporal expression of c-mos in mouse testis during postnatal development

Aim： To immunolocalize the c-mos gene product and to investigate its spatial and temporal expression in mouse testis during postnatal development. Methods： Semi-quantitative reverse transcription-polymerase chain reaction （RT- PCR） and in situ hybridization techniques were used to examine c-mos mRNA and indirect immunofluorescence was used to localize c-Mos protein in mouse testis on postnatal days 14, 21, 25, 28, 30, 35, 49 and 70. Results： c-mos mRNA remained low on postnatal days 14-21, increased abruptly from day 25 and peaked on day 30. Its levels decreased a little on day 35 and became almost stable thereafter until day 70. c-mos mRNA was localized in the nucleus and cytoplasm of the spermatocytes and round spermatids. The nuclear staining was much stronger than the cytoplasmic staining. Using a polyclonal anti-c-Mos antibody, Western blotting detected a single band at 43 kDa in testis lysate, c-Mos protein was exclusively localized to the elongating spermatids and was first detected on postnatal day 30. The number of c-Mos-positive spermatids increased progressively till day 49 and stabilized thereafter. Conclusion： The c-mos gene displays a spatial and temporal expression pattern in the mouse testis during postnatal development at both the mRNA and protein level. This suggests that c-mos might play important roles in spermatogenesis. （Asian J Androl 2008 Mar; 10： 277-285）

Does Antenatal Fear of Childbirth Predict Postnatal Fear of Childbirth? A Study of Japanese Women

The study aimed to determine whether antenatal fear of childbirth (expectation) could predict postnatal fear of childbirth (experience) by taking account of other antenatal psychological variables (anxiety and depression) as well as birth outcomes in Japanese women. A longitudinal observational study was conducted at a clinic in Tokyo, Japan, in 2011. Self-report questionnaires were distributed to 240 Japanese women at 37 gestational weeks (Time 1) and on the second day after delivery (Time 2). Regression analyses by means of structural equation modelling were conducted in both the primiparous and the multiparous group. The models exhibited good fit (chisquare value/degree of freedom = 1.10 - 1.62, comparative fit index = 0.92 - 0.99 and root mean square error of approximation = 0.03 - 0.07). Antenatal fear of childbirth was the most predictive variable of postnatal fear of childbirth in both the primiparous (β = 0.58, p = 0.002) and the multiparous group (β = 0.62, p < 0.001). In conclusion, antenatal fear of childbirth was a significant predictor of postnatal fear of childbirth when other antenatal psychological variables and birth outcomes were taken into account. Pregnant women who are strongly afraid of childbirth need special attention before and after delivery.

Developmental stage-specific A-to-I editing pattern in the postnatal pineal gland of pigs(Sus scrofa)

Background: RNA editing is a widespread post-transcriptional modification mechanism in mammalian genomes.Although many editing sites have been identified in domestic pigs(Sus scrofa), little is known about the characteristics and dynamic regulation of RNA editing in the pineal gland(PG), a small neuroendocrine gland that synthesizes and secretes melatonin, which is primarily responsible to modulate sleep patterns.Results: This study analyzed the expression of adenosine-to-inosine(A-to-I) editing regulators and profiled the first dynamic A-to-I RNA editome during postnatal PG development. The results identified ADAR1 as the most abundantly expressed ADAR enzyme, which was down-regulated during postnatal PG development. Furthermore,47,284 high-confidence RNA editing sites were identified, the majority of which(93.6%) were of the canonical A-to-I editing type, followed by C-to-T editing. Analysis of its characteristics showed that the A-to-I editing sites mostly localized in SINE retrotransposons PRE-1/Pre0_SS. Moreover, a strong deficiency and preference for guanine nucleotides at positions of one base upstream or downstream were found, respectively. The overall editing level at the puberty stage was higher than at both infancy and adulthood stages. Additionally, genome-wide RNA editing was found to exhibit a dynamic stage-specific fashion(postnatally). Genes that underwent developmental changes in RNA editing were associated with catabolic processes as well as protein localization and transport functions,implying that RNA editing might be responsible for the molecular machineries of the postnatal developing PG.Remarkably, RNA editing in 3′-UTRs might regulate gene expression by influencing miRNA binding during PG development.Conclusions: This study profiles the first comprehensive developmental RNA editome in the pig PG, which contributes to the understanding of the importance of post-transcriptionally mediated regulation during mammalian postnatal PG development. Moreover, this study widely extends RNA editome resources in mammals.

Localization of epididymal protease inhibitor in adult rat and its transcription profile in testis during postnatal development

To investigate the expression pattern of rat Eppin （epididymal protease inhibitor; official symbol Spinlwl）, we detected mRNA transcripts and subsequent protein translation of Eppin in several sorts of tissues by RT-PCR and westem blotting. Then immunohistochemistry was performed for more detailed observation. The testicular transcription level was monitored by real-time PCR throughout postnatal development. We found that rat Eppin was specifically expressed in the testis and epididymis. The testicular transcription was slight in neonatal （1-day） and infantile stages （5-, 7- and 10-day）. It increased sharply thereafter, with maximum expression level （about 38- fold compared with that of 1-day old rat） detected in prepubertal stage （15-day）. Then a slightly declined but stable level （about 20-fold compared with that of 1-day old rat） was kept in pubertal-early adult （30-day） and adult （60-day） stages of postnatal maturation. In the adult rat, EPPIN protein was mainly localized in the elongated spermatids and epididymal epithelial cells. Sperm in the epididymal duct were all covered with EPPIN and its level kept constant during incubation under conditions used to achieve capacitation. Its stage-specific expression in the testis suggests that EPPIN may be important during spermatogenesis especially for the spermatid elongation. The abundant production of epididymal EPPIN indicated indirectly that it might play a role in the function of the epididymis.

Nrf2 is required for normal postnatal bone acquisition in mice

A large body of literature suggests that bone metabolism is susceptible to the ill effects of reactive species that accumulate in the body and cause cellular dysfunction. One of the body＇s front lines in defense against such damage is the transcription factor, Nrf2. This transcription factor regulates a plethora of antioxidant and cellular defense pathways to protect cells from such damage. Despite the breadth of knowledge of both the function of Nrf2 and the effects of reactive species in bone metabolism, the direct role of Nrf2 in skeletal biology has yet to be thoroughly examined. Thus, in the current study, we have examined the role of Nrf2 in postnatal bone metabolism in mice. Mice lacking Nrf2 （Nrf2-/-） exhibited a marked deficit in postnatal bone acquisition, which was most severe at 3 weeks of age when osteoblast numbers were 12-fold less than observed in control animals. While primary osteoblasts from Nrf2-/- mice functioned normally in vitro, the colony forming capacity of bone marrow stromal cells （BMSCs） from these mice was significantly reduced compared to controls. This defect could be rescued through treatment with the radical scavenger N-acetyl cysteine （NAC）, suggesting that increased reactive species stress might impair early osteoblastogenesis in BMSCs and lead to the failure of bone acquisition observed in Nrf2-/- animals. Taken together, these studies suggest Nrf2 represents a key pathway in regulating bone metabolism, which may provide future therapeutic targets to treat osteoporosis.

Postnatal development of NADPH-diaphorase expression in the visual cortex of the golden hamster

Nitric oxide is an important neuromodulator in the brain and is involved in the development of visual system. But it is not clear how nitric oxide and nitric oxide synthase （NOS） are involved in the developing visual cortex of rodents. Thus we examined the expression of NOS activity in the postnatal developing visual cortex of the golden hamster by using histochemical technique for NADPH-diaphorase （NADPH-d）. A heavily stained NADPH-d band was observed in the neuropil of the visual cortex. This NADPH-d band initially appeared in the cortical plate from the day of birth （P0） to postnatal day 4 （P4）. From P7 to P21, this band was confined to area 17 and migrated to the deeper layers Ill IV and V VI before it eventually disappeared at P28. Such developmental trends of the band correlated well with the process of formation and establishment of the geniculo-cortical projection patterns. Thus, the areal specific development of the band suggests that NOS is closely related to the cortical differentiation and synaptic formation of the primary visual cortex. On the other hand, monocular eye enucleation on P1 could not alter the appearance of this NADPH-d positive band, indicating a non-activity dependant role of NOS. In addition, differences in the laminar distributions and developmental sequence between the heavily and lightly stained NADPH-d positive neurons during development suggest that they play different roles in the development.

A multiplatform metabolomic approach to characterize fecal signatures of negative postnatal events in chicks: a pilot study

Background: Negative experiences in early life can induce long-lasting effects on the welfare, health, and performance of farm animals. A delayed placement of chicks in rearing houses has negative effects on their performance, and results in fecal-specific odors detectable by rats. Based on this observation, the volatile organic compounds(VOCs) and metabolites from the feces of 12-day-old chickens were screened for early markers of response to negative events using gas-chromatography and liquid-chromatography coupled with mass spectrometry(GC-MS, LC-HRMS).Results: The low reproducibility of solid-phase micro-extraction of the VOCs followed by GC-MS was not suitable for marker discovery, in contrast to liquid extraction of metabolites from freeze-dried feces followed by GC-MS or LC-HRMS analysis. Therefore, the fecal metabolome from 12-day-old chicks having experienced a normal or delayed placement were recorded by GC-MS and LC-HRMS in two genotypes from two experiments. From both experiments, 25 and 35 metabolites, respectively explaining 81% and 45% of the difference between delayed and control chickens, were identified by orthogonal partial least-squares discriminant analysis from LC-HRMS and GC-MS profiling.Conclusion: The sets of molecules identified will be useful to better understand the chicks’ response to negative events over time and will contribute to define stress or welfare biomarkers.

Ontogeny of expression of transforming growth factor-βand its receptors and their possible relationship with scarless or scar-forming healing in human fetal and postnatal skins

Fetal eutaneous wounds that oeeur in earlygestation heal without sear formation.Althoughmueh work has been done to eharaeterize the roleof transforming growth

The Alexandria retinopathy of prematurity model(Alex-ROP): postnatal weight gain screening algorithm application in a developing country

AIM: To suggest a novel retinopathy of prematurity(ROP) screening model in developing countries incorporating postnatal weight gain ratios(PWGR) to traditional parameters to maintain sensitivity and improve specificity in detecting ROP. METHODS: Analysis of weekly PWGR of infants from one tertiary referral center during six months to determine the age at which the PWGR with the highest predictability for ROP development which was referred to as the postnatal net weight gain ratio(NWGR). NWGR was added to conventional criteria to describe a new model(The Alex-ROP model). RESULTS: Of 560 infants were included. NWGR 28 d after birth was the most predictive factor for the development of ROP. A new model Alex-ROP recommending screening infants with gestational age(GA) ≤33 wk or birth weight ≤1500 g and NWGR at 28 d after birth <0.3 was suggested. A second screening model referred to as High-grade AlexROP(Hg Alex-ROP) model to detect worse grade ROP(Both type 1 and type 2) recommending a cutoff point of NWGR <0.15 between birth and 28^(th) day. CONCLUSION: Both Alex-ROP and Hg Alex-ROP models are easy to apply to improve the specificity of ROP screening in developing countries while maintaining high sensitivity.

Zinc finger protein Zbtb20 is essential for postnatal survival and glucose homeostasis

To define the function of Zbtb20 in vivo,we generated knockout mice by homologous recombination.Zbtb20 null mice displayed a stark phenotype characterized by postnatal growth retardation,

Development and postnatal neurogenesis in the retina: a comparison between altricial and precocial bird species

The visual system is affected by neurodegenerative diseases caused by the degeneration of specific retinal neurons,the leading cause of irreversible blindness in humans.Throughout vertebrate phylogeny,the retina has two kinds of specialized niches of constitutive neurogenesis:the retinal progenitors located in the circumferential marginal zone and Müller glia.The proliferative activity in the retinal progenitors located in the circumferential marginal zone in precocial birds such as the chicken,the commonest bird model used in developmental and regenerative studies,is very low.This region adds only a few retinal cells to the peripheral edge of the retina during several months after hatching,but does not seem to be involved in retinal regeneration.Müller cells in the chicken retina are not proliferative under physiological conditions,but after acute damage some of them undergo a reprogramming event,dedifferentiating into retinal stem cells and generating new retinal neurons.Therefore,regenerative response after injury occurs with low efficiency in the precocial avian retina.In contrast,it has recently been shown that neurogenesis is intense in the retina of altricial birds at hatching.In particular,abundant proliferative activity is detected both in the circumferential marginal zone and in the outer half of the inner nuclear layer.Therefore,stem cell niches are very active in the retina of altricial birds.Although more extensive research is needed to assess the potential of proliferating cells in the adult retina of altricial birds,it emerges as an attractive model for studying different aspects of neurogenesis and neural regeneration in vertebrates.

Effects of protein restriction in utero on the metabolism of mink dams (<i>Neovison vison</i>) and on mink kit survival as well as on postnatal growth

Protein restriction in utero may give rise to restricted growth as well as induce metabolically related diseases. In order to determine the suitability of mink as an animal model for metabolism studies, the effects of protein restriction during gestation on dam and kit performance must first be determined. Mink dams were fed an adequate protein (AP;crude protein:fat:carbohydrate ratio of 31:55:14% of metabolizable energy, ME) or a low protein diet (LP;19%:49%: 32% of ME) during the last 21.2 ± 3.3 days of gestation, followed by an adequate diet during lactation. Respiration and balance experiments were performed during late gestation and twice during lactation. The dietary treatment only affected energy metabolism traits significantly during the treatment period in late gestation, such that LP dams oxidized less protein (12% vs 23% of heat production, HE, P = 0.001) but more carbohydrate (37% vs 26% of HE, P -0.75.day-1, P < 0.05) than AP dams. Reproductive performance and kit organ growth were not affected by diet. Kit losses up to weaning were higher in LP than AP dams (2.0 vs 1.4, P < 0.05). LP fetuses weighed less (8.3 vs 11.6 g, P < 0.001) and were shorter (6.2 vs 7.6 cm, P < 0.001) than AP fetuses, however, differences might have been due to different implantation times. LP kits weighed 8.5% less than AP kits at birth, and remained lighter until 21 days of age. The LP diet caused growth restriction and increased kit mortality indicating that the dietary protein supply during late gestation was suboptimal to re-quirements. The long-term consequences of protein restriction in utero in terms of permanent metabolic changes in adulthood now need to be investigated.

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region ofMalawi. The study design was descriptive cross sectional and utilized quantitative data collection and analysis method to determine structural, process and outcome components of postnatal care in two facilities that offer emergency obstetric and neonatal care and five that offer basic emergency obstetric and neonatal care. All 60 midwives who were providing postnatal care during the time of study in the district were interviewed using a structured questionnaire. In addition, the midwives actual practice was observed and compared to a standard checklist on postnatal care practice which was developed by the Malawi Ministry of Health. Data were analyzed using SPSS version 16.0. Results show that structure for providing postnatal counseling services was inappropriate and inadequate. Furthermore, the contents of postnatal services were below reproductive health standards because the clients were neither monitored nor examined physically on discharge. On average, all the seven facilities scored 48% on postnatal services rendered which is far below the recommended 80% according to the Reproductive Health Standards. There is a need to provide basic infrastructure in all the basic emergency obstetric and neonatal care facilities. In addition, refresher training courses for midwives in maternal and neonatal health with emphasis on postnatal care are recommended. There is also a need to restructure the maternal and neonatal health departments in the facilities so that the postnatal care units become stand-alone priority sites to improve the quality of the postnatal care services rendered.

Postnatal PMTCT: Women’s Perception Barriers at a Johannesburg Health Centre, South Africa

Background: Maximising women’s participation and ensuring optimal outcomes will require that the women’s perception barriers to postnatal prevention of Mother-to-Child Transmission (PMTCT) programme of HIV be addressed. However, little is known about women’s perception barriers to postnatal PMTCT programme of HIV and how these barriers affect the women’s health seeking behavior and uptake. Objective: This study sought to explore the women’s perception barriers to postnatal PMTCT programme at a Johannesburg Community Health Centre during April-May, 2016. Methods: A qualitative study on 30 women (aged 20 - 39 years) was conducted at a Johannesburg community health (CHC), South Africa, during May-June 2016, after obtaining their consent. The data was analysed thematically to understand women’s perception barriers to postnatal PMTCT programme. Results: The study found that inadequate counselling was perceived to be the single key health service barrier to PMTCT programme. At the individual level, adherence to ART was considered the leading women’s barriers to the postnatal PMTCT. Exclusive breastfeeding was, however, perceived as important women’s barriers to the postnatal PMTCT. Inadequate emotional support from families and community was a noteworthy women’s perception barrier to the programme. Conclusion: The study makes two recommendations: firstly, the staff, programme managers and health policy makers need to be aware of the women’s perception barriers to the postnatal PMTCT programme. Secondly, the programme should be strengthened by addressing perception barriers to the programme to enhance women participation to ensure optimal outcomes for women and their infants.

Postnatal Care within Six Hours Following Delivery at Two Selected General Hospitals of Zambia—Mothers’ Experiences

Background: The days and weeks following childbirth (the postnatal period or puerperium), are a critical phase in the lives of mothers and new-born babies. The most vulnerable time for both is during the few hours and days after birth. The period places major demands on the physiological processes of mother and new-born as they adapt the changes of pregnancy and intrauterine life respectively. However, this is the most neglected time for the provision of quality services. Postnatal care is an integral part of the midwife’s role in providing care and support to the individual mother and her baby. Postnatal care encompasses aspects of observing and monitoring the health of the mother and her baby, as well as offering support and guidance in breastfeeding and parenting skills. Aim of the study: The aim of the study was to explore the experiences and expectations of mothers concerning care during the immediate postnatal period. Methods and materials: A qualitative approach was utilised to collect data from mothers in their immediate postnatal period using recorded in-depth interviews. A total of thirty (30) mothers were interviewed from two general hospitals. Thematic content analysis was used to analyse the data. Findings: From the study, three main themes emerged;inadequate physical examination, information needs and professional support, and varied staff attitude. The findings of the study have highlighted the inadequacies that are still there regarding immediate postnatal care. Conclusion and recommendations: It can be concluded that mothers have a lot of needs and expectation during this period which are usually not met. One most important conclusion is the lack or poor information given to the women regarding the care of the new-born and subsequent care. This could be one of the reasons mothers do not come back for the subsequent postnatal visit. There is an evidence of poor quality of postnatal care being offered to women during the immediate postnatal period. There are also some negative experiences that postnatal mothers have had and these have led them to being unsatisfied with the care they receive during the immediate postnatal period. However, despite all the above, there is still room for improving the care given during this time. This can help reduce maternal and neonatal morbidity and mortality.

Predicting Postnatal Psychological Distress in a Zambian Cohort: Relationship between the EPDS and the GHQ-12

Postnatal mental distress is a public health problem and women screening positive of psychological distress who do not meet the diagnostic criteria for psychiatric disorder may be experiencing significant distress for which they might require assistance from mental health personnel. The risk of a woman experiencing psychological distress during the postnatal period can be predicted before it occurs. The study included 300 pregnant women who were selected systematically and on whom two assessments were conducted at two different points. The first assessment was conducted at 32-week gestation while the second one at six weeks following childbirth. The participants were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the General Health Questionnaire (GHQ-12). Analysis of Variance (ANOVA) was used to test the association between the EPDS and the GHQ-12 while logistic regression analysis was carried out in order to predict postnatal psychological distress. The results showed no significant difference between the socio-demographic characteristics and the EPDS score. A significant association was found between the GHQ-12 and EPDS scores (r = 0.545;p = 0.001). Logistic regression revealed that a single predictor, antenatal EPDS individual score, alone provided a highly adequate model and was statistically reliable in distinguishing between presence and absence of psychological distress in the postnatal period (&minus;2 log likelihood = 225.634;CI (1.035 - 1.173);X2 (1) 9.633, p = 0.002). The study revealed a correlation between EPDS score and GHQ-12 and that the EPDS can predict postnatal psychological distress using the data from the antenatal period. Therefore, patients who are found with antenatal psychological distress should be consistently evaluated throughout pregnancy and during the postnatal period to allow for early detection and intervention of postnatal psychological distress.

Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

Maternal mortality remains very high in developing countries. In Guinea, it is 550 maternal deaths in 100.000 living birth. More than half of these deaths occur in the postpartum period. Hence the interests to have a better understanding of the factors that hinder the realization of post-natal care (PNC) arise. It is for this reason that the objective of this study is to identify barriers to the use of post-natal care in Guinea. Methods: A qualitative study was conducted in the prefectures of Kindia and Dubréka, in the Administrative Region of Kindia (Guinea) in April and May 2014. Fourteen focus group discussions of women and girls of the community, as well as fifteen individual in-depth interviews (9 with women and 6 with healthcare providers). Results: Most women do their PNC during their child vaccination or in case of postpartum complications. Financial constraints are the main barrier to using postnatal care identified by participants. In general, distance from the health center associated with lack of transport mean and insufficient staffs are factors related to the health system. In addition, poor reception of clients, women’s experience during childbirth, poor programming for PNC as well as the lack of trust and confidentiality between clients and health care providers are the barriers related to health providers. The participants also mentioned the lack of sensitization and information as well as cultural constraints as barriers to using post-natal care. Conclusion: The removal of these barriers in the use of PNC will significantly reduce maternal and neonatal mortality in Guinea.