Breastfeeding and Postnatal Depression: A Prospective Cohort Study in Sabah, Malaysia

BACKGROUND: Postnatal depression is a disorder that can lead to serious consequences for both the mother and infant. Despite the extensively documented health benefits of breastfeeding, its association with postnatal depression remains uncertain. OBJECTIVE: To investigate the relationship between full breastfeeding at 3 months postpartum and postnatal depressive symptoms among mothers in Sabah, Malaysia. METHODS: A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36 to 38 weeks of gestation and followed up at 1 and 3 months postpartum. Depressive symptoms were assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale (EPDS). Repeated-measures analyses of variance was performed to compare the depression scores over time and between subgroups of breastfeeding mothers. RESULTS: Approximately 46% of women were fully breastfeeding their infants at 3 months postpartum. These mothers had significantly (P < .001) lower mean EPDS scores at both 1 and 3 months postpartum (mean ± SD, 4.14 ± 4.12 and 4.27 ± 4.12, respectively) than others who did not initiate or maintain full breastfeeding for 3 months (4.94 ± 4.34 and 5.25 ± 4.05, respectively). After controlling for the effects of covariates, the differences in EPDS scores remained statistically significant (P = .001) between the 2 breastfeeding groups. CONCLUSION: Full breastfeeding appeared to be negatively associated with postnatal depressive symptoms for mothers residing in Sabah

Swyer syndrome in a woman with pure 46, XY gonadal dysgenesis and a hypoplastic uterus

Swyer syndrome or pure 46, XY gonadal dysgenesis is a condition in which the individuals have female appearance. They classically present as sexually infantile phenotypic females with primary amenorrhoea. People with this disorder have female external genitalia but the uterus and fallopian tubes are underdeveloped. However, they do not have functional gonads (ovaries or testes). Instead, they have streak gonads. We are reporting a case of Swyer syndrome with partially developed breasts, hypoplastic uterus, and absent streak gonads. The patient was treated with hormonal therapy and few years after her presentation, breast and uterine development were noted. In view that the patient is already married, the option of fertility was discussed with her. This case illustrates a rare case of gonadal dysgenesis and demonstrates the importance of counseling on the options of treatment, especially regarding fertility

Pedometer-based walking intervention with and without group support among sedentary adults in primary care patients in north-east Malaysia: a randomized controlled trial

Background: Many studies have shown that pedometer is an effective motivational tool to promote walking however there is lack of evidence which combines pedometer and group support in motivating patient to increase their physical activityObjective: To determine the effectiveness of pedometer and group support versus pedometer only on physical activity level and cardiovascular risk factors among sedentary adults in north-east MalayMethods: This was a prospective randomized comparative trial. Eighty participants were randomly assigned to pedometer-based walking program plus group support ( N=40) or pedometer-based walking program only (N=40) for 12 weeks. Both groups received physical activity counselling. The intervention group had monthly group meeting for support, motivation and also walking activities. Measurements for step-counts, 7-day physical activity recall, body mass, BMI, waist and hip circumference, blood pressure, total cholesterol, HDL cholesterol and fasting blood sugar were taken at baseline and at week 12. Analyses were performed using repeated measures ANOVA and analysis of co-variance (ANCOVA).Results and Discussion: Sixty two participants completed the study. The mean age in the intervention group were 48 (4.43) years old and 47 (5.08) years old in the control group. There were significant improvements in the intervention group in terms of step-counts (p &lt; 0.001), weight (P&lt;0.05) and BMI (p&gt;0.05) compared to control group. However there was no significant difference in term of other health outcome.Conclusion A pedometer-based walking program, incorporating a physical activity consultation and group support, is effective in promoting walking and improving health outcome in community based individuals. Studies of longer duration need to be done to see the sustainability of the above intervention.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.52-57</jats:p