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1.
J Int Med Res ; 49(11): 3000605211054706, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34738473

RESUMO

OBJECTIVE: The aim of this study was to examine the risk factors for antepartum hemorrhage (APH) in women with placenta previa. METHODS: In this retrospective cohort study, we analyzed the medical records of 233 women with singleton pregnancies presenting with placenta previa whose deliveries were performed at our hospital between January 2009 and July 2018. RESULTS: Of the 233 women included in this study, 130 (55.8%) had APH. In the APH group, the gestational age and neonatal birth weight were significantly lower compared with the no hemorrhage group. Maternal age <30 years and multiparity were identified as significant risk factors for APH in both the univariate and multivariate analyses. Focusing on the previous route of delivery in multiparous women, the risk of APH was significantly higher in multiparous women who had experienced at least one vaginal delivery compared with nulliparous women (adjusted odds ratio (OR): 3.42 [95% confidence interval: 1.83-6.38]). CONCLUSION: We showed that women with placenta previa who were under 30 years old and who had a history of vaginal delivery may be at significant risk of experiencing APH.


Assuntos
Placenta Prévia , Adulto , Feminino , Humanos , Recém-Nascido , Paridade , Placenta Prévia/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Hemorragia Uterina
2.
Schweiz Arch Tierheilkd ; 164(11): 721-736, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34758949

RESUMO

INTRODUCTION: The impact of lameness on fertility in dairy cows has already been investigated, however predominantely in Holstein cows. The aim of this study was to evaluate the impact of lameness during the dry period, between calving and first service and between calving and conception (days open) on selected fertility traits in Austrian Fleckvieh cows. Locomotion scoring of dairy cows was performed during the course of routine performance testing in 2014 and 2015. Using the observed maximum locomotion score (MLSC) during pre- and postcalving periods, the cows were classified into three groups: cows never lame (MLSC 1), cows that showed MLSC 2, and cows with MLSC ≥3 during these defined periods. Data sets of 3,998 lactations of 3,058 Austrian Fleckvieh cows from 97 dairy herds could be evaluated. In several statistical models the fixed effects of MLSC (1, 2, ≥ 3), farm, year and season of calving, parity*age class at calving, and early fertility disorders were considered for analysis of the traits days from calving to first insemination, interval from first to last insemination, days from calving to conception and calving interval (CI), as well as the non-return-rate90 (NRR90). Mean lameness prevalence during the dry period was 19,43 %, and reached 27,70 % in the period between calving and conception. Lameness (MLSC ≥ 3) during the dry period significantly (P = 0,030) prolonged the period between calving and conception, and lameness (MLSC ≥ 3) during the period from calving to first service had a significantly detrimental effect on the periods calving to first insemination, days open and CI (P < 0,001). Further, highly significant associations (P < 0,001) in cows showing MLSC ≥ 2 during the period between calving and conception on all fertility traits were determined. Apart from lameness, farm, year and season of calving, parity*-age class at calving, early fertility disorders and, partly, the interaction of the latter two effects significantly (P.


Assuntos
Fertilidade , Coxeadura Animal , Animais , Áustria/epidemiologia , Bovinos , Feminino , Lactação , Coxeadura Animal/epidemiologia , Paridade , Gravidez
3.
J Contemp Dent Pract ; 22(8): 933-938, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34753847

RESUMO

AIM AND OBJECTIVE: This study aims to investigate the association between parity and dental caries among US women. MATERIALS AND METHODS: National Health and Nutrition Examination Survey (NHANES 2001-2004) data for parous women aged 20-45 years were used for our analysis (n = 1,914). The association between parity (number of pregnancies resulted in live births) and caries experience [the decayed, missing, and filling teeth (DMFT) index] was analyzed using bivariate and multivariate regression analyses. SAS software version 9.1 was used for the statistical analyses. We used survey procedures (e.g., SURVEYFREQ, SURVEYMEANS, and SURVEYREG) that incorporate information on the appropriate weights to account for NHANES's complex sampling design. RESULTS: The bivariate analysis showed a trend of increase in dental caries experience among parous women as the number of live births increased (p = 0.007). After adjusting for confounders, such as age, socioeconomic status (SES), dental care coverage, and utilization, a significant association was still observed between parity level and dental caries experience (p = 0.009). CONCLUSION: Our results suggest that higher parity can be associated with dental caries experience among US women of reproductive age. CLINICAL SIGNIFICANCE: Clinicians should be aware of this finding to promote better oral health care and education among women with increased parity.


Assuntos
Cárie Dentária , Índice CPO , Assistência Odontológica , Cárie Dentária/epidemiologia , Feminino , Humanos , Inquéritos Nutricionais , Saúde Bucal , Paridade , Gravidez , Prevalência
4.
BMC Health Serv Res ; 21(1): 1261, 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34802452

RESUMO

BACKGROUND: Development in Eastern Indonesia tends to be left behind compared to other Indonesian regions, including development in the health sector. The study aimed at analyzing the health insurance ownership disparities in hospital delivery in Eastern Indonesia. METHODS: The study draws on secondary data from the 2017 Indonesia Demographic and Health Survey. The study population was women aged 15-49 years who had given birth in the last five years in Eastern Indonesia. The study analyzes a weighted sample size of 2299 respondents. The study employed hospital-based birth delivery as a dependent variable. Apart from health insurance ownership, other variables analyzed as independent variables are province, residence type, age group, marital status, education level, employment status, parity, and wealth status. The final stage analysis used binary logistic regression. RESULTS: The results showed that insured women were 1.426 times more likely than uninsured women to undergo hospital delivery (AOR 1.426; 95% CI 1.426-1.427). This analysis indicates that having health insurance is a protective factor for women in Eastern Indonesia for hospital delivery. There is still a disparity between insured and uninsured women in hospital-based birth deliveries in eastern Indonesia. Insured women are nearly one and a half times more likely than uninsured women to give birth in a hospital. CONCLUSION: The study concludes that there are health insurance ownership disparities for hospital delivery in eastern Indonesia. Insured women have a better chance than uninsured women for hospital delivery.


Assuntos
Seguro Saúde , Propriedade , Feminino , Hospitais , Humanos , Indonésia , Paridade , Gravidez
5.
Tidsskr Nor Laegeforen ; 1412021 09 28.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-34597001

RESUMO

BACKGROUND: Previous caesarean section is considered the main risk factor for uterine rupture. However, other surgical procedures performed on the uterus can also lead to rupture in future pregnancies. CASE PRESENTATION: The patient was a nulliparous woman, induced at gestational age of 41 + 6 with misoprostol. She developed severe persistent abdominal pain. Due to fetal bradycardia, an acute caesarean section was performed. Peroperatively a large rupture was identified in the uterine fundus and the placenta was detached into the abdomen. Medical history included a previous rightsided salpingectomy due to an extrauterine pregnancy located in the interstitial part of the right Fallopian tube. INTERPRETATION: Interstitial extrauterine pregnancy is rare, and recommendations for mode of delivery for subsequent pregnancies remain unclear. The current case illustrates the importance of being aware of the risk of rupture when the patient has undergone previous gynaecological surgery other than caesarean section, and of ensuring awareness of the placenta's location.


Assuntos
Misoprostol , Complicações na Gravidez , Ruptura Uterina , Cesárea , Feminino , Humanos , Paridade , Gravidez , Ruptura Uterina/etiologia , Ruptura Uterina/cirurgia
6.
J Prev Med Hyg ; 62(2): E439-E446, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34604585

RESUMO

Background: Antenatal care is essential care given during pregnancy, to diagnose and treat complications that could endanger both the lives of mother and child. The risk of dying from pregnancy-related issues is often associated with a lack of access to antenatal care services. This issue is a prominent matter in developing countries such as Somaliland which has one of the highest maternal mortality rates in the world. Objective: The objective of this study is to determine the frequency and timing of antenatal care utilization and factors influencing it among reproductive-age women. Methods: A population-based cross-sectional survey is conducted among 330 randomly selected mothers who gave birth in the past two years in Borama, Somaliland. Result: Although a significant number of women utilized antenatal care in their pregnancy only 31.1% initiated the first visit within the first trimester and 48.3% received less than the recommended four visits. Fewer antenatal care visits are significantly associated with age (OR = 3.018; CI = 1.264-7.207), gravida (OR = 3.295; CI = 1.200-9.045), and gestation age (OR = 1.737; CI = 1.013-2.979). Early marriage (OR=0.495; CI = 0.252-0.973), and large family size (OR = 3.952; CI = 1.330-11.742) are associated with delay in the commencement of the first antenatal care visit. Conclusion: Young women, women with multiple pregnancies, women married at a young age, and women with a large family size have a higher probability of delaying prenatal care and having fewer visits. Based on the findings, uplifting the socioeconomic status and literacy level of women through community-based education and developing strategies that would take the determining factors into account may contribute to improved and adequate utilization of antenatal care.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Classe Social , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Idade Materna , Pessoa de Meia-Idade , Paridade , Vigilância da População , Gravidez , Fatores Socioeconômicos , Somália
7.
Arq Gastroenterol ; 58(3): 302-307, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34705963

RESUMO

BACKGROUND: Few studies have investigated the constipation or obstructed defecation symptoms identified by using imaging, as dynamic three-dimensional ultrasound and correlate vaginal delivery, parity, and age. OBJECTIVE: The aim of this study was to assess the prevalence of pelvic floor dysfunctions in female patients with obstructed defection symptoms and to determine whether specific pelvic floor dysfunctions identified by dynamic three-dimensional ultrasonography (echodefecography) are correlated with vaginal delivery, parity, and age. The secondary goal is to report the prevalence of coexisting pelvic floor dysfunctions. METHODS: This is a retrospective cohort study including patients with obstructed defecation symptoms underwent echodefecographyto evaluate pelvic floor dysfunctions in the posterior compartment and correlate with vaginal delivery, parity, and age. RESULTS: Of 889 female: 552 (62%) had had vaginal delivery and 337 (38%) were nulliparous. The prevalence of dysfunctions identified by echodefecography (rectocele, intussusception, enterocele/sigmoidocele, and dyssynergia) was similar between the two groups and was not associated with number of deliveriesor age. However, the prevalence of sphincter defects showed higher rates in women with vaginal delivery and increased with the parity. Up to 33% of patients had coexisting dysfunctions. CONCLUSION: The prevalence of dysfunctions such as rectocele, intussusception, dyssynergia, and enterocele/sigmoidocele assessed by echodefecography in patients with obstructed defecation symptoms are found similar regardless of vaginal delivery, number of deliveries or stratified-age. In vaginal delivery, number of deliveries does impact on detection of sphincter defects and liability to fecal incontinence.


Assuntos
Defecação , Diafragma da Pelve , Constipação Intestinal/diagnóstico por imagem , Constipação Intestinal/epidemiologia , Constipação Intestinal/etiologia , Parto Obstétrico , Feminino , Humanos , Paridade , Diafragma da Pelve/diagnóstico por imagem , Gravidez , Estudos Retrospectivos , Ultrassonografia
8.
Theriogenology ; 176: 122-127, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34601236

RESUMO

High-quality follicles result in larger corpora lutea (CL), producing more progesterone, and having a fundamental role in pregnancy maintenance. For some sows, follicular growth takes place during lactation, and follicle selection occurs under a catabolic environment. As altrenogest inhibits follicular development, this study aimed to evaluate follicular growth, CL size, estrus expression, and subsequent reproductive performance of sows treated with altrenogest during the last seven days of a three-week lactation. A total of 81 primiparous and 319 multiparous sows were allocated to two treatments: CONT (control group) and ALT (20 mg of altrenogest/day during the last seven days of lactation). Subsamples of 20 primiparous sows and 97 multiparous were randomly selected to evaluate follicular growth and 26 multiparous sows for serum progesterone analysis at day 21 of gestation. On day 21 of pregnancy, CL measurement was performed by ultrasound. Once in estrus, sows were post-cervically inseminated with pooled semen doses with 1.5 × 109 sperm cells at estrus onset and every 24 h during the standing reflex period. Sows not showing estrus until 10 days after weaning were considered in anestrus. The variables weaning-to-estrus interval, CL size, litter size in the subsequent cycle, and piglet birth weight were evaluated using the GLIMMIX procedure and compared using the Tukey-Kramer test. Anestrus, pregnancy, farrowing, and adjusted farrowing rate were evaluated as binary responses using logistic regression. Follicular size was analyzed as a repeated measure during treatment and after weaning. Treatment was considered as a fixed effect. During the treatment period, follicular size was smaller in ALT sows than CONT sows (3.29 vs. 3.52 mm; P < 0.001). However, after treatment, ALT sows showed a larger follicular size than CONT sows (5.30 vs. 5.03 mm; P ≤ 0.01). There were less ALT sows showing estrus than CONT sows on days three (1.03 vs. 4.57%) and four (55.38 vs. 68.02%) after weaning (P ≤ 0.05), respectively. At 21 days after insemination, ALT sows showed larger CL size and lower CL size variation (P < 0.01) than CONT sows. Anestrus rate, pregnancy rate, farrowing rate, adjusted farrowing rate, litter size in the subsequent cycle, piglet birth weight, litter birth weight, and birth weight variation did not differ between treatments (P ≥ 0.14). In conclusion, altrenogest treatment during the last week of lactation concentrated estrus expression on day five after weaning, larger follicle and CL sizes; however, with no improvement in reproductive performance.


Assuntos
Lactação , Acetato de Trembolona , Animais , Feminino , Tamanho da Ninhada de Vivíparos , Paridade , Gravidez , Reprodução , Suínos , Acetato de Trembolona/análogos & derivados , Acetato de Trembolona/farmacologia , Desmame
9.
Indian Heart J ; 73(5): 622-628, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34627580

RESUMO

BACKGROUND: To examine the role of parity in coronary heart disease (CHD) among middle-aged Indian women living in government-designated slums in Mysore, India. METHODS: Between October 2017 and May 2018, a cross-sectional study was carried out among women, 40-64 years of age, residing in government-designated slums in Mysore, India. In addition to socio-demographics, data were collected on CVD risk factors including use of tobacco and alcohol, diet, physical activity, sleep, quality of life, and personal and family history of chronic disease. Patients underwent a medical examination and a venous blood sample was taken for fasting lipid measurement. Resting electrocardiography was carried out by a trained medical technician. Multivariable logistic regression with associated 95% confidence intervals was used to examine the relationship between parity and coronary heart disease. RESULTS: The prevalence of CHD in this sample of middle-aged women was 6.4%. Nulliparous women were at heightened risk for CHD compared to parous women with up to five live births. In the adjusted model, women who had 1-2 and 3-5 live births had 0.24 times lower odds (95% Confidence Interval [CI]: 0.05-1.29) and 0.38 times lower odds (95%CI: 0.178-0.87) of CHD, respectively, as compared to nulliparous women. CONCLUSION: Among a fairly homogenous population of slum-dwelling women reporting almost universal breastfeeding for three or more months following birth, parity up to five births appeared protective against CHD. Further studies are needed to evaluate whether near universal breastfeeding rates in this population mediated the relationship of parity and CHD.


Assuntos
Doença das Coronárias , Áreas de Pobreza , Doença das Coronárias/epidemiologia , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Paridade , Gravidez , Qualidade de Vida , Fatores de Risco
10.
Artigo em Inglês | MEDLINE | ID: mdl-34682473

RESUMO

The Robson ten-group classification system is a recognized effective method of assessing caesarean rate. It is based on dividing patients into ten mutually exclusive groups, focusing on six maternal and newborn variables (parity, gestational age, plurality, foetal presentation, previous caesarean, and mode of labour onset). The aim of our analysis was twofold: first, to present the implementation of Robson classification in a pregnant teenage population; and second, to identify the indications for CS in the adolescent population. This study was designed as a one-year prospective analysis and considered all women younger than 20 years of age who delivered in a tertiary care hospital. Before discharge, women who had caesarean delivery responded to a questionnaire regarding their education, prenatal surveillance, and obstetrical history. Caesarean sections accounted for 47.01% of all births. A proportion of 24.57% of the participants had at least one previous caesarean section. Group 10 (all women with a single cephalic preterm pregnancy) was second most often identified among women in middle adolescence (14.03%); 32.20% of the participants in late adolescence were in group 5 (multiparas with a scarred uterus, single cephalic term pregnancy). Differences between the two age groups were not statistically different (p = 0.96). Abnormal cardiotocographic findings (38.23%), the arrest of descent (19.11%) and arrest of dilation (19.11%), were the most frequent indications for caesareans in Robson group 1. Neonates from mothers in Robson groups 8 (women with a multiple pregnancy) and 7 (multiparas single breech pregnancy) had the most unfavourable outcomes regarding gestational age at delivery and admission to the intensive care unit. We concluded that future focus on obstetrical management is mandatory in Robson groups 7 and 8. Adolescents in Robson group 1 (nulliparas, single cephalic term pregnancy, spontaneous labour) are the primary beneficiaries of strategies to reduce caesarean sections rates.


Assuntos
Cesárea , Mães , Adolescente , Feminino , Humanos , Recém-Nascido , Apresentação no Trabalho de Parto , Paridade , Gravidez , Romênia/epidemiologia
11.
Theriogenology ; 175: 61-68, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34500128

RESUMO

Retained placenta (RP) is as an important reproductive disorder which adversely affects the economic performance of dairy cows. Understanding the consequences and economic losses associated with RP can persuade dairy farmers to consider it more effectively in their management decisions. Hence, the aims of this research were to assess the effect of RP on production and reproduction attributes as well as economic losses in Iranian Holstein cows. The data was collected from nine Holstein dairy herds in Isfahan province of Iran. The final dataset comprised of 139,508 records of 58,086 cows which calved between March 2011 and December 2018. A linear mixed model was developed to evaluate the effect of RP on individual performance of primiparous and multiparous cows. The economic losses associated with the RP were finally estimated. The average incidence of RP per cow over a year was 12.3% (ranged between 9.0 and 15.4%). Each incidence of RP significantly reduced milk, fat and protein yields in primiparous and multiparous cows (P < 0.05). The adverse effect of RP on the milk production was much higher in the cows at the early phase of lactation (i.e. 100-d lactation group) than the cows in mid or late lactation. The estimated production losses (±standard deviation) due to the RP event were 282.1 ± 43.0 and 295.7 ± 40.8 kg per cow for a 305-d lactation period in primiparous and multiparous cows, respectively. However, the fertility performance was less affected by the RP in primiparous compared to multiparous cows. The average of days open increased by 8.3 ± 5.3 and 19.8 ± 7.1 d in primiparous and multiparous cows, respectively. The financial losses associated with RP were on average US$ 350.4 and US$ 481.2 per incidence in primiparous and multiparous cows, respectively, ranged from US$ 311.9 to 456.2 depending on the parity number (primi- or multiparous) and herd management. The highest financial losses due to RP were associated with reduction in milk production (38.5% of total loss) and low fertility (28.5% of total loss) had the highest contribution in in primiparous and multiparous cows, respectively. The results of our research highlight the economic importance of improved calving management to reduce RP occurrence in dairy cows.


Assuntos
Doenças dos Bovinos , Placenta Retida , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Feminino , Irã (Geográfico)/epidemiologia , Lactação , Leite , Paridade , Placenta Retida/epidemiologia , Placenta Retida/veterinária , Gravidez
12.
Theriogenology ; 175: 95-99, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34521031

RESUMO

So far, no study has been conducted on the effect of milk protein concentrations (MP%) in different time periods of lactation on subsequent calving intervals (CI). The purpose of this study was to evaluate the association between MP% at different stages of the first to fourth lactations and subsequent calving intervals in primiparous and multiparous Holstein dairy cows. Test day records (3X milking frequency) of milk yield measured on primiparous (n = 503793) and multiparous (n = 389237, 257347, 156035 and 87750 for parity 2, 3 and 4, and 5 respectively) Holstein dairy cows collected during 1984-2019 were obtained from Animal Breeding Center of Iran. To investigate the relationship between MP% at different time intervals of lactation and subsequent calving intervals (up to fifth parity), each lactation was divided into four time periods (≤50d, 50 < d ≤ 100, 100 < d ≤ 200 and 200 < d ≤ 305). At each period, protein concentrations were also divided into three classes: 1-3%, 3-5%, 5-7%. There was a negative relationship between MP% in the first 50 days of first lactation in primiparous and multiparous dairy cows and subsequent calving intervals in a way that calving intervals decreased as MP% increased and the shortest calving intervals were observed for the third class of milk protein concentrations. After the first 50 days of first lactation, the shortest subsequent calving intervals were detected for the second class of MP% and the CI increased non-significantly when MP% increased to 5-7. In general, due to the significant relationship between MP% and subsequent CI, this relationship can be further considered in breeding programs in dairy cattle.


Assuntos
Lactação , Proteínas do Leite , Animais , Bovinos , Feminino , Irã (Geográfico) , Leite , Paridade , Gravidez
13.
Nat Commun ; 12(1): 5448, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521855

RESUMO

Mechanical forces in a constrained cellular environment were recently established as a facilitator of chromosomal damage. Whether this could contribute to tumorigenesis is not known. Uterine leiomyomas are common neoplasms that display relatively few chromosomal aberrations. We hypothesized that if mechanical forces contribute to chromosomal damage, signs of this could be seen in uterine leiomyomas from parous women. We examined the karyotypes of 1946 tumors, and found a striking overrepresentation of chromosomal damage associated with parity. We then subjected myometrial cells to physiological forces similar to those encountered during pregnancy, and found this to cause DNA breaks and a DNA repair response. While mechanical forces acting in constrained cellular environments may thus contribute to neoplastic degeneration, and genesis of uterine leiomyoma, further studies are needed to prove possible causality of the observed association. No evidence for progression to malignancy was found.


Assuntos
Aberrações Cromossômicas , Reparo do DNA , Leiomioma/genética , Complexo Mediador/genética , Paridade , Neoplasias Uterinas/genética , Adulto , Fenômenos Biomecânicos , Quebras de DNA de Cadeia Dupla , Feminino , Expressão Gênica , Humanos , Histerectomia , Cariótipo , Leiomioma/etiologia , Leiomioma/patologia , Leiomioma/cirurgia , Mutação , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/patologia , Miométrio/metabolismo , Miométrio/patologia , Gravidez , Cultura Primária de Células , Estudos Prospectivos , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
14.
Eur J Endocrinol ; 185(5): 755-763, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34524975

RESUMO

Aim: To assess whether in women with gestational diabetes mellitus (GDM), postpartum plasma glycated CD59 (pGCD59) levels predict conversion to glucose intolerance diagnosed with an oral glucose tolerance test (OGTT). Methods: Blood levels of pGCD59 were measured in a case-control study of 105 women with GDM who underwent a 75 g OGTT 3 months postpartum. The 35 postpartum glucose intolerant cases were individually matched for age, BMI, ethnic origin, and parity with 70 women with GDM but normal postpartum OGTT (controls). The GDM cohort (105) was also matched with 105 normal glucose tolerant women during pregnancy. pGCD59 was measured by ELISA in standard peptide units (SPU). Results: Mean pGCD59 postpartum was significantly higher in cases than in controls (1.5 ± 0.6 SPU vs 1.0 ± 0.6 SPU, P < 0.001). The area under the receiving operating characteristic curve (AUC) in cases vs controls was 0.72 (95% CI: 0.62-0.83) for postpartum pGCD59 and 0.50 (95% CI: 0.36-0.61) for postpartum HbA1c. A 0.5-unit increase in postpartum pGCD59 was associated with an odds ratio (OR) of 3.3 (95% CI: 1.82-6.16, P < 0.001) for glucose intolerance postpartum. A pGCD59 cut-off postpartum of 0.9 SPU had a sensitivity of 85.7% (95% CI: 69.7-95.2%), specificity of 47.8% (95% CI: 35.6-60.2%), positive predictive value of 45.4% (95% CI: 33.1-58.2%), and negative predictive value of 86.8% (95% CI: 71.9-95.6%). pGCD59 in pregnancy was a poor predictor for glucose intolerance postpartum (AUC of 0.61 (95% CI: 0.50-0.72)). Conclusion: pGCD59 might identify women at low risk for glucose intolerance postpartum and could help to avoid an OGTT.


Assuntos
Antígenos CD59/análise , Diabetes Gestacional/sangue , Intolerância à Glucose/sangue , Período Pós-Parto/sangue , Adulto , Área Sob a Curva , Glicemia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Intolerância à Glucose/etiologia , Hemoglobina A Glicada/análise , Humanos , Paridade , Valor Preditivo dos Testes , Gravidez , Estudos Prospectivos , Sensibilidade e Especificidade , Adulto Jovem
15.
Animal ; 15(10): 100346, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34547549

RESUMO

Forages can contribute to the nutrient supply for sows but the extent to which they can replace concentrate feeding is not well known. The objective of this study was to assess the effect of level of feed restriction and type of forage on the performance and activity of gestating sows under outdoor conditions. A total of 45 sows were distributed among three treatments, with five replicates of three sows/treatment, from week 5 of gestation until farrowing. Treatments differed in the daily level of concentrate feed provided and the type of forage offered during gestation: 90% of metabolisable energy (ME) requirements provided by concentrates and free access to a pasture (P90); 40% of ME requirements provided by concentrates and free access to a pasture (P40); and 40% of ME requirements provided by concentrates and free access to a bare paddock with hay ad libitum (H40). From farrowing to weaning (5 weeks), concentrate feed was offered to all sows ad libitum. Body weight and backfat thickness (BF) were measured seven times during gestation and lactation. Postures of sows and time spent in the pasture were assessed at the beginning, middle and end of gestation. Forage intake was estimated with a method based on sow performance using the InraPorc® model. At farrowing, P90 sows were heavier and had greater BF than P40 and H40 sows. At weaning, P90 sows maintained a higher BW and tended to have greater BF than H40 sows, but no longer differed from P40 sows. Treatments did not influence litter size, but piglets from P40 sows were lighter at birth than those from P90 sows (1.44 vs. 1.69 kg, P = 0.004). In late gestation, P90 sows spent less time standing over 24 h and less time in the pasture during daytime than P40 sows, suggesting less foraging behaviour. Sows fed concentrates to meet 40% of ME requirements during gestation did not consume enough forage to maintain the same body condition as sows fed at 90% of ME requirements. Despite their inability to fully compensate for concentrate restriction during gestation by consuming more forage, P40 sows reached a similar body condition to P90 sows at weaning. In conclusion, forage intake for outdoor gestating sows can compensate a concentrate feed reduction of 10% and possibly more, but not as much as 60%.


Assuntos
Ração Animal , Dieta , Ração Animal/análise , Animais , Dieta/veterinária , Feminino , Lactação , Tamanho da Ninhada de Vivíparos , Paridade , Gravidez , Suínos , Desmame
16.
Animal ; 15(10): 100363, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34562696

RESUMO

Daily milk production, and fluctuations therein, can provide information on health and resilience of dairy cows. We studied variance and autocorrelation of deviations in daily milk yield in relation to the occurrence of clinical mastitis (no, early or later in lactation). Individual lactation curves were fitted to 305-d lactations of 414 dairy cows using quantile regression. Log-transformed variance (lnVar) and autocorrelation of the quantile residuals of daily milk yield (predicted - observed) were evaluated for intervals until 30 and until 305 days in milk (DIM). Cows were classified as having no mastitis (n = 249), early mastitis that first occurred before 30 DIM (n = 29); or later mastitis (n = 136). Subsequently, linear models were used to assess effects of mastitis and parity class (primiparous or multiparous) on lnVar and autocorrelations; and logistic regression analyses were performed to predict mastitis from lnVar or autocorrelation and parity. From 10 to 30 DIM, lnVar was greater for cows with early mastitis than for cows with no or late mastitis, and autocorrelation tended to be lower for cows with early mastitis than for cows with no mastitis. The lnVar and autocorrelation from 10 to 30 DIM were not predictive of late mastitis. From 10 to 305 DIM, lnVar was greater and autocorrelation was lower for both cows with early and late mastitis than for cows with no mastitis; and both were predictive of having mastitis in the 305-d lactation. Primiparous cows had lower lnVar than multiparous cows. In cows without mastitis, autocorrelation values were positively correlated with lnVar. Results confirm that increased lnVar is associated with clinical mastitis.


Assuntos
Doenças dos Bovinos , Mastite Bovina , Mastite , Animais , Bovinos , Feminino , Lactação , Mastite/veterinária , Leite , Paridade , Gravidez
17.
Prev Vet Med ; 196: 105475, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34481225

RESUMO

This cross-sectional observational study aimed to identify prepartum management, environmental, and animal factors associated with clinical -lameness, metritis, mastitis- and subclinical -calcium imbalance, magnesium imbalance- diseases in pasture-based dairy cows. A total of 565 cows from 25 commercial dairy farms in southern Chile were enrolled over four months. Data on prepartum management and environmental conditions were obtained through a survey and inspections of prepartum paddocks. Cows were evaluated two times. In the first evaluation, between 30 to 3 days before calving, cows were assessed for lameness, body condition score, and blood samples were collected to measure nonesterified fatty acid (NEFA), calcium (Ca), and magnesium (Mg). In the second evaluation, between 3 to 21 DIM, cows were assessed for metritis, lameness, and blood samples were collected and analyzed for total Ca and Mg concentration. Cows were considered as having Ca imbalance if Ca < 2.0 mmol/L, and Mg imbalance if Mg < 0.65 mmol/L. Postpartum clinical mastitis was diagnosed based on the foremilk's daily condition and udder assessed by the milker at each milking during the postpartum transition period. Multivariable logistic regression models, controlling for the farm as a random effect, were built to identify prepartum factors for each postpartum disease. The odds of postpartum lameness were higher for cows that were lame during the prepartum period, had elevated prepartum NEFA concentrations, had greater parity, and for cows that were kept in paddocks with no grass cover. The odds of metritis were higher in cows with lower parity, with increased prepartum NEFA, in cows that had dystocia, and farms with predominantly Holstein breed, and that did not have calving records. The odds of clinical mastitis were higher for cows lame during the prepartum period. The odds of Ca imbalance were higher in cows with a long dry period, dystocic calving, and in farms without prepartum anionic salts supplementation. The odds of Mg imbalance were higher in cows with lower prepartum Mg concentrations, higher prepartum Ca concentration, and higher parity. Our findings indicate that farmers could benefit from refining these areas to improve their cows' health and welfare.


Assuntos
Doenças dos Bovinos/etiologia , Período Pós-Parto , Animais , Cálcio/sangue , Bovinos , Chile , Estudos Transversais , Indústria de Laticínios , Ácidos Graxos não Esterificados/sangue , Feminino , Magnésio/sangue , Leite , Paridade , Gravidez
18.
BMC Cancer ; 21(1): 1017, 2021 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-34511060

RESUMO

BACKGROUND: Neutrophils are important for immune surveillance of tumour cells. Neutrophils may also be epigenetically programmed in the tumour microenvironment to promote tumour progression. In addition to the commonly known high-density neutrophils (HDN) based on their separation on density gradient, recent studies have reported the presence of high levels of low-density neutrophils (LDN) in tumour-bearing mice and cancer patients. We reported previously that estrogen promotes the growth of estrogen receptor α-negative mammary tumours in mice undergoing mammary involution through stimulating pro-tumoral activities of neutrophils in the mammary tissue. METHODS: Female BALB/cAnNTac mice at 7-8 weeks old were mated and bilateral ovariectomy was performed 2 days post-partum. At 24 h after forced-weaning of pups to induce mammary involution, post-partum female mice were injected with either E2V, or vehicle control on alternative days for 2-weeks. On 48 h post-weaning, treated female mice were inoculated subcutaneously with 4 T1-Luc2 cells into the 9th abdominal mammary gland. Age-matched nulliparous female was treated similarly. Animals were euthanized on day 14 post-tumour inoculation for analysis. To evaluate the short-term effect of estrogen, post-partum females were treated with only one dose of E2V on day 12 post-tumour inoculation. RESULTS: Estrogen treatment for 2-weeks reduces the number of blood LDN by more than 10-fold in tumour-bearing nulliparous and involuting mice, whilst it had no significant effect on blood HDN. The effect on tumour-bearing mice is associated with reduced number of mitotic neutrophils in the bone marrow and increased apoptosis in blood neutrophils. Since estrogen enhanced tumour growth in involuting mice, but not in nulliparous mice, we assessed the effect of estrogen on the gene expression associated with pro-tumoral activities of neutrophils. Whilst 48 h treatment with estrogen had no effect, 2-weeks treatment significantly increased the expression of Arg1, Il1b and Tgfb1 in both HDN and LDN of involuting mice. In contrast, estrogen increased the expression of Arg1 and Ccl5 in HDN and LDN of nulliparous mice. CONCLUSIONS: Prolonged estrogenic stimulation in tumour-bearing mice markedly hampered tumour-associated increase of LDN plausibly by inhibiting their output from the bone marrow and by shortening their life span. Estrogen also alters the gene expression in neutrophils that is not seen in tumour-free mice. The results imply that estrogen may significantly influence the tumour-modulating activity of blood neutrophils.


Assuntos
Estrogênios/farmacologia , Neoplasias Mamárias Animais/sangue , Neutrófilos/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Arginase/genética , Arginase/metabolismo , Biomarcadores Tumorais/metabolismo , Células da Medula Óssea/citologia , Centrifugação com Gradiente de Concentração , Estrogênios/administração & dosagem , Feminino , Citometria de Fluxo , Expressão Gênica/efeitos dos fármacos , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Glândulas Mamárias Animais , Camundongos , Camundongos Endogâmicos BALB C , Transplante de Neoplasias , Neutrófilos/citologia , Neutrófilos/metabolismo , Ovariectomia/métodos , Paridade , Período Pós-Parto , Fatores de Tempo , Fator de Crescimento Transformador beta1/genética , Fator de Crescimento Transformador beta1/metabolismo
19.
Arq. gastroenterol ; 58(3): 302-307, July-Sept. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1345301

RESUMO

ABSTRACT BACKGROUND: Few studies have investigated the constipation or obstructed defecation symptoms identified by using imaging, as dynamic three-dimensional ultrasound and correlate vaginal delivery, parity, and age. OBJECTIVE: The aim of this study was to assess the prevalence of pelvic floor dysfunctions in female patients with obstructed defection symptoms and to determine whether specific pelvic floor dysfunctions identified by dynamic three-dimensional ultrasonography (echodefecography) are correlated with vaginal delivery, parity, and age. The secondary goal is to report the prevalence of coexisting pelvic floor dysfunctions. METHODS: This is a retrospective cohort study including patients with obstructed defecation symptoms underwent echodefecographyto evaluate pelvic floor dysfunctions in the posterior compartment and correlate with vaginal delivery, parity, and age. RESULTS: Of 889 female: 552 (62%) had had vaginal delivery and 337 (38%) were nulliparous. The prevalence of dysfunctions identified by echodefecography (rectocele, intussusception, enterocele/sigmoidocele, and dyssynergia) was similar between the two groups and was not associated with number of deliveriesor age. However, the prevalence of sphincter defects showed higher rates in women with vaginal delivery and increased with the parity. Up to 33% of patients had coexisting dysfunctions. CONCLUSION: The prevalence of dysfunctions such as rectocele, intussusception, dyssynergia, and enterocele/sigmoidocele assessed by echodefecography in patients with obstructed defecation symptoms are found similar regardless of vaginal delivery, number of deliveries or stratified-age. In vaginal delivery, number of deliveries does impact on detection of sphincter defects and liability to fecal incontinence.


RESUMO CONTEXTO: Poucos estudos investigaram pacientes portadoras de defecação obstruída identificados por exames de imagens, como ultrassonografia tridimensional dinâmica, correlacionando parto vaginal, paridade e idade. OBJETIVO: O objetivo deste estudo foi avaliar a prevalência de disfunções do assoalho pélvico em pacientes do sexo feminino com sintomas de defecação obstruída e determinar se disfunções específicas do assoalho pélvico identificadas por ultrassonografia tridimensional dinâmica (ecodefecografia) estão correlacionadas com parto vaginal, paridade e idade. O objetivo secundário é relatar a prevalência de disfunções do assoalho pélvico coexistentes. MÉTODOS: Este é um estudo de coorte retrospectivo incluindo pacientes com sintomas de obstrução da defecação submetidas à ecodefecografia para avaliar disfunções do assoalho pélvico no compartimento posterior e correlacionar com parto vaginal, paridade e idade. RESULTADOS: De 889 mulheres: 552 (62%) tiveram parto vaginal e 337 (38%) eram nulíparas. A prevalência de disfunções identificadas pela ecodefecografia (retocele, intussuscepção, enterocele/sigmoidocele e dissinergia) foi semelhante entre os dois grupos e não foi associada ao número de partos ou à idade. No entanto, a prevalência de defeitos esfincterianos apresentou taxas mais elevadas em mulheres com parto vaginal e aumentou com a paridade. Até 33% dos pacientes apresentavam disfunções coexistentes. CONCLUSÃO: A prevalência de disfunções como retocele, intussuscepção, dissinergia e enterocele/sigmoidocele avaliada pela ecodefecografia em pacientes com sintomas de defecação obstruída são semelhantes independentemente do parto normal, número de partos ou idade estratificada. No parto vaginal, o número de partos tem impacto na detecção de defeitos esfincterianos e na possibilidade de incontinência fecal.


Assuntos
Humanos , Feminino , Gravidez , Diafragma da Pelve/diagnóstico por imagem , Defecação , Paridade , Estudos Retrospectivos , Ultrassonografia , Constipação Intestinal , Constipação Intestinal/etiologia , Constipação Intestinal/epidemiologia , Parto Obstétrico
20.
Sex Reprod Healthc ; 30: 100657, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34482211

RESUMO

OBJECTIVE: To investigate associations between the duration of the active second stage of labour and adverse maternal and neonatal outcomes. METHOD: This cohort study is based on data from a cluster randomised controlled trial (RCT) undertaken at 14 Norwegian birth clinics in Norway from 2014 to 2017. The final sample involved 6804 nulliparous women with a singleton fetus, cephalic presentation, spontaneous onset of labour at term, vaginal delivered and with an active second stage of labour. The women were grouped to active second stage of labour ≤ 60 min and active second stage of labour > 60 min. Binary logistic regression was used to estimate crude and adjusted odds ratios (ORs) of the maternal and neonatal outcomes with an associated 95% confidence intervals (CIs), comparing women in the two groups. RESULTS: There was an increased risk of postpartum haemorrhage > 1000 ml with an adjusted OR 1.31 (95% CI: 1.01-1.69) when the active second stage of labour exceeded 60 min. There was no significant difference in the risk of obstetric anal sphincter injuries (adjusted OR 0.93 [95% CI: 0.65-1.39]), Apgar scores < 7 at 5 min age (adjusted OR 1.13 [95% CI: 0.65-1.97]) or admission to the neonatal intensive care unit (adjusted OR 1.46 [95% CI: 0.61-3.51]) between the study groups. CONCLUSION: Women with an active second stage of labour that exceeds 60 min had an increased risk of postpartum haemorrhage > 1000 ml. We found no association between duration of active stage of labour and obstetric anal sphincter injuries or adverse neonatal outcomes.


Assuntos
Segunda Fase do Trabalho de Parto , Hemorragia Pós-Parto , Índice de Apgar , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Paridade , Hemorragia Pós-Parto/etiologia , Gravidez
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