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1.
Rev. enferm. UERJ ; 29: e56037, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1151921

RESUMEN

Objetivo: mapear as evidências disponíveis na literatura acerca dos manejos e desfechos da infecção pelo novo coronavírus no puerpério. Método: revisão de escopo conforme o Institute Joanna Briggs, desenvolvida em quatro fontes de dados eletrônicas. A extração, análise e síntese dos dados foi realizada por quatro pesquisadores independentes. Resultados: Nove publicações foram revisadas de 188 localizadas. Seis foram os países produtores das evidências, todas obtidas e publicadas em 2020. Vinte e um casos de COVID-19 no puerpério estiveram tratados nestas publicações, sendo 15 (71,4%) relativos a evoluções graves/exacerbação da doença e seis (28,6%) diagnosticados após a alta hospitalar. Conclusão: O mapeamento aponta para a ocorrência da infecção ou seu agravamento no período pós-parto, com indicativas ao monitoramento de sinais e sintomas, exploração diagnóstica e tratamento acurado e necessidade de acompanhamento próximo das mulheres diagnosticadas com COVID-19, sintomáticas ou não, no período pós-parto.


Objective: to map the evidence available in the literature about management and outcomes of postpartum infection by the new coronavirus. Method: scoping review conducted in four electronic sources, following Joanna Briggs Institute guidelines. Data were extracted, analyzed and summarized by four researchers independently. Results: nine of the 188 publications located were reviewed. The evidence, all obtained and published in 2020, was produced in six countries. These publications considered 21 cases of postpartum COVID-19, 15 (71.4%) of which related to severe developments / exacerbation of the disease and six (28.6%) diagnosed after hospital discharge. Conclusion: the mapping points to the occurrence of infection or worsening of the disease in the postpartum period, indicating the need for monitoring of signs and symptoms, diagnostic exploration and accurate treatment and the need for close monitoring of postpartum women diagnosed with COVID-19, whether symptomatic or not.


Objetivo: mapear las evidencias disponibles en la literatura sobre el manejo y los resultados de la infección por el nuevo coronavirus en el período posparto. Método: revisión del alcance según el Instituto Joanna Briggs, desarrollada en cuatro fuentes de datos electrónicas. La extracción, el análisis y la síntesis de los datos fueron realizados por cuatro investigadores independientes. Resultados: se revisaron nueve publicaciones de 188 encontradas. Fueron seis los países que produjeron las evidencias, obtenidas y publicadas en 2020. En estas publicaciones se trataron 21 casos de COVID-19 en el período posparto, 15 (71,4%) de los cuales estaban relacionados con evoluciones graves/exacerbación de la enfermedad y seis (28,6%) diagnosticados tras el alta hospitalaria. Conclusión: el mapeo apunta hacia la ocurrencia de la infección o su agravamiento en el posparto, con indicaciones de seguimiento de indicios y síntomas, exploración diagnóstica, tratamiento preciso y la necesidad de un seguimiento cercano a las mujeres diagnosticadas con COVID-19, sintomáticas o no, en el período posparto.


Asunto(s)
Humanos , Femenino , Embarazo , Salud de la Mujer , Periodo Posparto , COVID-19 , COVID-19/terapia , COVID-19/epidemiología , Revisión , Infecciones por Coronavirus , Periodo Posparto/sangre , COVID-19/diagnóstico
2.
Res Nurs Health ; 44(4): 608-619, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33993510

RESUMEN

Multiple physiological changes occur in pregnancy as a woman's body adapts to support the growing fetus. These pregnancy-induced changes are essential for fetal growth, but the extent to which they reverse after pregnancy remains in question. For some women, physiological changes persist after pregnancy and may increase long-term cardiometabolic disease risk. The National Institutes of Health-funded study described in this protocol addresses a scientific gap by characterizing weight and biological changes during pregnancy and an extended postpartum period in relation to cardiometabolic risk. We use a longitudinal repeated measures design to prospectively examine maternal health from early pregnancy until 3 years postpartum. The aims are: (1) identify maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk profiles three years postpartum; (2) describe immune, endocrine, and metabolic biomarker profiles in the pregnancy-postpartum period, and determine their associations with cardiometabolic risk; and (3) determine how modifiable postpartum health behaviors (diet, physical activity, breastfeeding, sleep, stress) (a) predict weight and cardiometabolic risk in the postpartum period; and (b) moderate associations between postpartum weight retention and downstream cardiometabolic risk. The proposed sample is 250 women. This study of mothers is conducted in conjunction with the Understanding Pregnancy Signals and Infant Development study, which examines child health outcomes. Biological and behavioral data are collected in each trimester and at 6, 12, 24, and 36 months postpartum. Findings will inform targeted health strategies that promote health and reduce cardiometabolic risk in childbearing women.


Asunto(s)
Lactancia Materna , Factores de Riesgo Cardiometabólico , Ejercicio Físico , Madres/estadística & datos numéricos , Periodo Posparto , Aumento de Peso/fisiología , Adulto , Dieta , Femenino , Conductas Relacionadas con la Salud , Humanos , Lactante , Estudios Longitudinales , Periodo Posparto/sangre , Embarazo , Estudios Prospectivos , Sueño/fisiología , Adulto Joven
3.
J Clin Endocrinol Metab ; 106(7): 1887-1899, 2021 06 16.
Artículo en Inglés | MEDLINE | ID: mdl-33792735

RESUMEN

CONTEXT: Postpartum depression (PPD) is a serious psychiatric disorder. While causes remain poorly understood, perinatal sex hormone fluctuations are an important factor, and allopregnanolone in particular has emerged as a key determinant. Although synthetic environmental chemicals such as bisphenols and phthalates are known to affect sex hormones, no studies have measured allopregnanolone and the consequences of these hormonal changes on PPD have not been interrogated. OBJECTIVE: To investigate associations of repeated measures of urinary bisphenols and phthalates in early and midpregnancy with serum pregnenolone, progesterone, allopregnanolone, and pregnanolone concentrations in midpregnancy and PPD symptoms at 4 months postpartum. METHODS: Prospective cohort study of 139 pregnant women recruited between 2016 and 2018. Bisphenols and phthalates were measured in early and midpregnancy urine samples. Serum sex steroid hormone concentrations were measured in midpregnancy. PPD was assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multiple informant models were fit using generalized estimating equations. Serum levels of allopregnanolone, progesterone, pregnanolone, and pregnenolone were examined as log-transformed continuous variables. PPD symptoms were examined as continuous EPDS scores and dichotomously with scores ≥10 defined as PPD. RESULTS: Di-n-octyl phthalate (DnOP) and diisononyl phthalate (DiNP) metabolites were associated with reduced progesterone concentrations. Log-unit increases in ∑DnOP and ∑DiNP predicted 8.1% (95% CI -15.2%, -0.4%) and 7.7% (95% CI -13.3%, -1.7%) lower progesterone, respectively. ∑DnOP was associated with increased odds of PPD (odds ratio 1.48; 95% CI 1.04, 2.11). CONCLUSION: Endocrine disrupting chemicals may influence hormonal shifts during pregnancy as well as contribute to PPD.


Asunto(s)
Compuestos de Bencidrilo/toxicidad , Depresión Posparto/inducido químicamente , Disruptores Endocrinos/toxicidad , Exposición Materna/efectos adversos , Fenoles/toxicidad , Ácidos Ftálicos/toxicidad , Adulto , Femenino , Humanos , Neuroesteroides/sangre , Periodo Posparto/sangre , Periodo Posparto/psicología , Embarazo , Trimestres del Embarazo/sangre , Pregnanolona/sangre , Pregnenolona/sangre , Progesterona/sangre , Estudios Prospectivos , Escalas de Valoración Psiquiátrica
4.
Ann Clin Biochem ; 58(5): 452-460, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33730872

RESUMEN

BACKGROUND: Early recognition of sepsis and prompt treatment improves patient outcome. C-reactive protein is a sensitive marker for tissue damage and inflammation, but procalcitonin has greater specificity for bacterial infection. Limited research exists regarding the use of C-reactive protein and procalcitonin at term pregnancy and the immediate postpartum period. AIM: This study sought to define reference values for C-reactive protein and procalcitonin at term and the early postnatal period. METHODS: A prospective cross-sectional study was performed in a university teaching hospital. Venous blood was collected from healthy women (n = 196), aged between 19 and 45 years with an uncomplicated singleton pregnancy, at term (37-40 weeks' gestation) and on day 1 and day 3 postpartum for the measurement of C-reactive protein and procalcitonin. RESULTS: The reference population comprised of 189 participants: term pregnancy (n = 51), postpartum day 1 vaginal delivery (n = 70) and caesarean section (n = 38) and day 3 (caesarean section, n = 30). The maximum procalcitonin value at term pregnancy was 0.1 µg/L. On day 1 postpartum, 90% and 86.8% of procalcitonin results for vaginal delivery and caesarean section, respectively, were below the decision-threshold of 0.25 µg/L. The specificity of procalcitonin to rule out infection in the reference population was 91.5%. CONCLUSIONS: Reference values for procalcitonin were established in a well-characterized population of healthy pregnant women at term and immediately postpartum. The variability of C-reactive protein limits its clinical utility in the assessment of systemic sepsis. Application of the procalcitonin cut-off of 0.25 µg/L in this population will be a valuable adjunct to clinicians ruling out infection in pregnancy and postpartum.


Asunto(s)
Proteína C-Reactiva/metabolismo , Periodo Posparto/sangre , Tercer Trimestre del Embarazo/sangre , Embarazo/sangre , Polipéptido alfa Relacionado con Calcitonina/sangre , Adulto , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos
5.
PLoS One ; 16(3): e0248559, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33711066

RESUMEN

BACKGROUND: Long-term viral load (VL) suppression among HIV-positive, reproductive-aged women on ART is key to eliminating mother-to-child transmission (MTCT) but few data exist from sub-Saharan Africa. We report trends in post-partum VL in Malawian women on ART and factors associated with detectable VL up to 24 months post-partum. METHODS: 1-6 months post-partum mothers, screened HIV-positive at outpatient clinics in Malawi, were enrolled (2014-2016) with their infants. At enrollment, 12- and 24-months post-partum socio-demographic and PMTCT indicators were collected. Venous samples were collected for determination of maternal VL (limit of detection 40 copies/ml). Results were returned to clinics for routine management. RESULTS: 596/1281 (46.5%) women were retained in the study to 24 months. Those retained were older (p<0.01), had higher parity (p = 0.03) and more likely to have undetectable VL at enrollment than those lost to follow-up (80.0% vs 70.2%, p<0.01). Of 590 women on ART (median 30.1 months; inter-quartile range 26.8-61.3), 442 (74.9%) with complete VL data at 3 visits were included in further analysis. Prevalence of detectable VL at 12 and 24 months was higher among women with detectable VL at enrollment than among those with undetectable VL (74 detectable VL results/66 women vs. 19/359; p<0.001). In multivariable analysis (adjusted for age, parity, education, partner disclosure, timing of ART start and self-reported adherence), detectable VL at 24 months was 9 times more likely among women with 1 prior detectable VL (aOR 9.0; 95%CI 3.5-23.0, p<0.001) and 226 times more likely for women with 2 prior detectable VLs (aOR 226.4; 95%CI 73.0-701.8, p<0.001). CONCLUSIONS: Detectable virus early post-partum strongly increases risk of ongoing post-partum viremia. Due to high loss to follow-up, the true incidence of detectable VL over time is probably underestimated. These findings have implications for MTCT, as well as for the mothers, and call for intensified VL monitoring and targeted adherence support for women during pregnancy and post-partum.


Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Estudios de Seguimiento , Infecciones por VIH , VIH-1/metabolismo , Periodo Posparto/sangre , Complicaciones Infecciosas del Embarazo , Adulto , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Malaui/epidemiología , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/epidemiología , Carga Viral , Viremia/sangre , Viremia/tratamiento farmacológico , Viremia/epidemiología
6.
PLoS One ; 16(2): e0233943, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33606706

RESUMEN

This study evaluated the effects of treatment with meloxicam (a non-steroidal anti-inflammatory drug), parity, and blood progesterone concentration on the dynamics of the uterine microbiota of 16 clinically healthy postpartum dairy cows. Seven primiparous and 9 multiparous postpartum Holstein cows either received meloxicam (0.5 mg/kg SC, n = 7 cows) once daily for 4 days (10 to 13 days in milk (DIM)) or were untreated (n = 9 cows). Endometrial cytology samples were collected by cytobrush at 10, 21, and 35 DIM, from which the microbiota analysis was conducted using 16S rRNA gene sequence analysis. A radioimmunoassay was used to measure progesterone concentration in blood serum samples at 35 DIM and cows were classified as ˃ 1 ng/mL (n = 10) or ≤ 1 ng/mL (n = 6). Alpha diversity for bacterial genera (Chao1, Shannon-Weiner, and Camargo's evenness indices) were not affected by DIM, meloxicam treatment, parity, or progesterone category. For beta diversity (genera level), principal coordinate analysis (Bray-Curtis) showed differences in microbiota between parity groups. At the phylum level, the relative abundance of Actinobacteria was greater in primiparous than multiparous cows. At the genus level, there was lesser relative abundance of Bifidobacterium, Lactobacillus, Neisseriaceae, Paracoccus, Staphylococcus, and Streptococcus and greater relative abundance of Bacillus and Fusobacterium in primiparous than multiparous cows. Bray-Curtis dissimilarity did not differ by DIM at sampling, meloxicam treatment, or progesterone category at 35 DIM. In conclusion, uterine bacterial composition was not different at 10, 21, or 35 DIM, and meloxicam treatment or progesterone category did not affect the uterine microbiota in clinically healthy postpartum dairy cows. Primiparous cows presented a different composition of uterine bacteria than multiparous cows. The differences in microbiota associated with parity might be attributable to changes that occur consequent to the first calving, but this hypothesis should be investigated further.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Industria Lechera , Microbiota/efectos de los fármacos , Paridad , Periodo Posparto/sangre , Progesterona/sangre , Útero/microbiología , Animales , Bacterias/efectos de los fármacos , Bovinos , Análisis Discriminante , Endometrio/efectos de los fármacos , Femenino , Meloxicam/farmacología , Leche/química , Filogenia , Embarazo , Útero/efectos de los fármacos
7.
Dis Colon Rectum ; 64(6): 724-734, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-33591046

RESUMEN

BACKGROUND: Hemorrhoidal disease in women during pregnancy is common in clinical practice. However, prospective data on its real prevalence and women's demographics are scarce. OBJECTIVE: The aim of this study was to determine the prevalence of hemorrhoidal disease during pregnancy and to assess its impact on quality of life. In addition, this study aimed to identify the relationship between patients' characteristics, bowel habits, hormonal changes, and the presence of symptomatic hemorrhoids. DESIGN: This is a prospective longitudinal cohort study. SETTING: This study was conducted in the Obstetrics Department for pregnancy follow-up. PATIENTS: The patients evaluated were a cohort of pregnant women. INTERVENTION: The study was designed to follow a homogeneous cohort of women for 15 months. Visits took place in the first and third trimesters of pregnancy, and 3 and 6 months after delivery. Women's demographics (age, medical history, bowel habit, Bristol stool scale) and serum determination of pregnancy-related hormones (estrogen, progesterone, and relaxin) were determined. MAIN OUTCOME MEASURES: The primary outcome was the development of hemorrhoidal disease. RESULTS: Overall, 109 women (mean age, 31.2 ± 5.4 years) were included in the study. The prevalence of symptoms and physical findings of hemorrhoidal disease was present in 11% in the first trimester, 23% in the third trimester, 36.2% at 1 month after delivery, and 16.9% at 3 months after delivery. A medical history of hemorrhoidal disease was significantly associated with the diagnosis of hemorrhoids in the first trimester (p < 0.0001) and third trimester (p = 0.005). Symptoms of constipation were associated with this clinical disorder in the first trimester (p = 0.011) and the third trimester of pregnancy (p = 0.022). No association was found between hormonal changes and the development of hemorrhoidal disease. LIMITATIONS: A larger sample would provide more information. CONCLUSIONS: The prevalence of women with hemorrhoidal disease increases during pregnancy and after delivery. A history of hemorrhoidal disease and constipation is significantly associated with the diagnosis of symptomatic hemorrhoidal disease. See Video Abstract at http://links.lww.com/DCR/B504. INFLUENCIA DEL HBITO INTESTINAL Y LOS CAMBIOS HORMONALES EN EL DESARROLLO DE LA ENFERMEDAD HEMORROIDAL DURANTE EL EMBARAZO Y EL PERODO POSTERIOR AL PARTO UN ESTUDIO DE COHORTE PROSPECTIVO: ANTECEDENTES:La enfermedad hemorroidal en mujeres durante el embarazo es común en la práctica clínica. Sin embargo, hay escasos datos prospectivos sobre su prevalencia real y la demografía de las mujeres.OBJETIVO:El objetivo fue determinar la prevalencia de enfermedad hemorroidal durante el embarazo y evaluar su impacto en la calidad de vida. Además, identificar la relación entre las características de los pacientes, los hábitos intestinales, los cambios hormonales y la presencia de hemorroides sintomáticas.DISEÑO:Estudio prospectivo de cohorte longitudinal.AJUSTE:Este estudio se realizó en el Departamento de Obstetricia para el seguimiento del embarazo.PACIENTES:Una cohorte de mujeres embarazadas.INTERVENCIÓN:El estudio se diseñó para realizar un seguimiento de una cohorte homogénea de mujeres durante 15 meses. Las visitas se realizaron en el primer y tercer trimestre del embarazo, y a los 3 y 6 meses después del parto. Se determinaron los datos demográficos de las mujeres (edad, antecedentes médicos, hábito intestinal, escala de heces de Bristol) y la determinación sérica de hormonas relacionadas con el embarazo (estrógeno, progesterona y relaxina).PRINCIPALES MEDIDAS DE RESULTADO:El resultado principal fue el desarrollo de enfermedad hemorroidal.RESULTADOS:Se incluyó en el estudio a 109 mujeres (edad media, 31,2 ± 5,4 años). La prevalencia de síntomas y hallazgos físicos de enfermedad hemorroidal estuvo presente en 11% en el primer trimestre, 23% en el tercer trimestre, 36,2% 1 mes después del parto y 16,9% 3 meses después del parto. Un historial médico previo de enfermedad hemorroidal se asoció significativamente con el diagnóstico de hemorroides en el primer trimestre (p <0,0001) y tercer trimestre (p = 0,005). Los síntomas de estreñimiento se asociaron con este trastorno clínico en el primer trimestre (p = 0,011) y el tercer trimestre del embarazo (p = 0,022), respectivamente. No se encontró asociación entre los cambios hormonales y el desarrollo de enfermedad hemorroidal.LIMITACIONES:Una muestra más grande proporcionaría más información.CONCLUSIONES:La prevalencia de mujeres con enfermedad hemorroidal aumentó durante el embarazo y el posparto. El antecedente de enfermedad hemorroidal y estreñimiento se asociaron significativamente con el diagnóstico de enfermedad hemorroidal sintomática. Consulte Video Resumen en http://links.lww.com/DCR/B504.


Asunto(s)
Estreñimiento/epidemiología , Defecación/fisiología , Hemorroides/epidemiología , Hormonas/sangre , Adulto , Estreñimiento/complicaciones , Estreñimiento/diagnóstico , Femenino , Hábitos , Hemorroides/diagnóstico , Hemorroides/fisiopatología , Hemorroides/psicología , Hormonas/fisiología , Humanos , Estudios Longitudinales , Periodo Posparto/sangre , Periodo Posparto/fisiología , Embarazo/fisiología , Trimestres del Embarazo , Prevalencia , Estudios Prospectivos , Calidad de Vida
8.
Res Vet Sci ; 135: 167-174, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33524827

RESUMEN

Metritis in dairy cows is classified as a puerperal disease that affects all layers of the uterine epithelium and occurs during the first 21 days after parturition. The objectives of this study were to identify potential predictive biomarkers of metritis, to monitor the biochemical profile of pre-metritic dairy cows, and to evaluate the reproductive performance of dairy cows with metritis. Fifty-five cows without metritis and fifteen cows that showed clinical signs of metritis were enrolled in this study. Blood samples were collected at -21, -14 and - 7 days before calving and at parturition and assayed for urea, creatinine, aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), total cholesterol, fibrinogen, total calcium, ß-hydroxybutyrate (BHB) and non-esterified fatty acids (NEFA) concentrations. Serum fibrinogen on 21, 14 and 7 days prepartum and at parturition was the strongest discriminator between metritic and control cows. Moreover, metritic cows had lower (P < 0.05) concentrations of urea, creatinine, cholesterol and calcium and higher (P < 0.05) serum AST, GGT activities, and serum fibrinogen, BHB and NEFA concentrations when compared to control cows. The number of days to first ovulation, insemination, services per pregnancy and days to pregnancy were greater (P < 0.05) for metritic cows than the control group, and the follicle size was smaller (P < 0.05) for metritic cows than the control group. Our results indicate alterations in the biochemical profile of dairy cows with metritis and the negative impact on the reproductive performance of metritic cows raised in tropical conditions. In addition, this study showed that the serum fibrinogen could be used as screening biomarkers to indicate cows that might have metritis during the postpartum period.


Asunto(s)
Enfermedades de los Bovinos/sangre , Endometritis/veterinaria , Parto , Animales , Biomarcadores/sangre , Estudios de Casos y Controles , Bovinos , Enfermedades de los Bovinos/diagnóstico , Endometritis/sangre , Femenino , Lactancia , Periodo Posparto/sangre , Valor Predictivo de las Pruebas , Embarazo , Reproducción , Clima Tropical
9.
Trop Anim Health Prod ; 53(1): 73, 2021 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-33400003

RESUMEN

In postpartum buffaloes, the process of uterine involution and changes in blood metabolic profile has not been studied in relation to development of subclinical endometritis (SCE). In this study, buffaloes (n = 100) approaching calving were identified. Weekly blood samples were collected on the day of calving up to 6 weeks post-calving. The diameter of uterine horns and onset of ovarian cyclicity (corpus luteum) were recorded through ultrasonography. On the basis of polymorphonuclear cell (PMN) cell count in endometrial cytology at days 45-50 postpartum, buffaloes were divided into two groups, viz., with SCE (> 5% PMN; n = 38) and without SCE (≤ 5% PMN; n = 62). Buffaloes with SCE took longer (P < 0.05) time to complete uterine involution and had larger (P < 0.05) uterine horn diameter between 3rd and 6th weeks postpartum and lower prostaglandin F2α metabolite (PGFM) concentration on the day of calving (P < 0.05) and 1 week (P < 0.001) post-calving than without SCE group. Buffaloes with SCE had lower (P < 0.001) concentration of glucose at weeks 2 and 3, higher (P < 0.001) ß-hydroxybutyric acid (BHBA) at week 3, and lower serum albumin concentration throughout the sampling period (P < 0.05 to 0.001) except at 1 week post-calving as compared to without SCE group. The urea concentration was significantly lower (P < 0.05 to 0.001) in buffaloes with SCE from 4 weeks post-calving onwards than without SCE group. The calcium concentration was lower in buffaloes with SCE at weeks 5 (P < 0.001) and 6 (P < 0.05) postpartum, whereas the concentration of magnesium and phosphorus was uniform between the two groups. No significant (P > 0.05) difference in onset of ovarian cyclicity between the 2 groups was observed, whereas buffaloes with SCE had longer (P = 0.001) median days open (141 days) than their counterpart (117 days). The first service conception rate, cumulative pregnancy rate, and pregnancy rate at 150 days postpartum were lower (P < 0.05) in buffaloes with SCE than without SCE group. In summary, higher BHBA and lower serum concentrations of glucose, albumin, urea, and calcium control onset of subclinical endometritis which in turn has negative impact on fertility of buffaloes.


Asunto(s)
Búfalos/fisiología , Endometritis/veterinaria , Fertilidad , Periodo Posparto/sangre , Útero/anatomía & histología , Ácido 3-Hidroxibutírico/sangre , Animales , Glucemia/metabolismo , Búfalos/sangre , Calcio/sangre , Endometritis/epidemiología , Endometritis/fisiopatología , Endometrio/citología , Endometrio/metabolismo , Femenino , Magnesio/sangre , Fósforo/sangre , Periodo Posparto/fisiología , Embarazo , Prevalencia , Albúmina Sérica/análisis , Ultrasonografía/veterinaria , Urea/sangre , Útero/diagnóstico por imagen , Útero/fisiología
10.
Arch Med Res ; 52(1): 84-92, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33067012

RESUMEN

BACKGROUND: Low vitamin D levels have been implicated in postpartum depressive disorders. However, studies on bioavailable vitamin D levels in postpartum depression are limited. Our study aimed to assess the serum concentrations of total, free and bioavailable 25-hydroxyvitamin D (25(OH)D) levels in women with postpartum depressive symptoms (PPD) and the association between 25(OH)D levels and PPD at 6 week post-delivery. METHODS: In this cross-sectional study, a total of 330 cases and 330 age and BMI matched controls were recruited from the tertiary care hospital in South India. Women with depressive symptoms were assessed using the validated Edinburg Postnatal Depression Scale (EPDS) and cut-off score ≥10 was used. Serum 25(OH)D and VDBP levels were measured using commercially available ELISA kits. RESULTS: Serum total, free and bioavailable 25(OH)D levels were significantly lower in postpartum depressive women compared to non-depressive women (p <0.001, p = 0.01). A significant negative correlation was observed between 25(OH)D, free 25(OH)D and bioavailable 25(OH)D with EPDS score in total study subjects (p <0.001, r = -0.19; p <0.001, r = -0.14 and p <0.001, r = -0.14). Multivariate linear regression analysis further confirmed a significant association between serum total, free and bioavailable 25(OH)D levels and EPDS score (p <0.001∗). CONCLUSIONS: Our study demonstrated that lower serum total, free and bioavailable 25(OH)D levels were associated with postpartum depressive symptoms. Hypovitaminosis D after delivery may be a risk factor for postpartum depression.


Asunto(s)
Depresión Posparto/etiología , Proteína de Unión a Vitamina D/sangre , Vitamina D/análogos & derivados , Vitamina D/sangre , Adulto , Estudios de Casos y Controles , Estudios Transversales , Depresión Posparto/sangre , Depresión Posparto/epidemiología , Femenino , Humanos , India/epidemiología , Pruebas de Detección del Suero Materno , Periodo Posparto/sangre , Periodo Posparto/psicología , Embarazo , Factores de Riesgo , Vitamina D/metabolismo , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Proteína de Unión a Vitamina D/metabolismo , Adulto Joven
11.
Res Vet Sci ; 135: 335-342, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33153762

RESUMEN

The objectives were to evaluate differences in serum concentration of metabolites, macro minerals and hepatic enzymes at pre and postpartum time-points in dairy cows diagnosed with clinical metritis, hypocalcaemia or ketosis postpartum. A total of 144 Holstein cows from 11 commercial dairy herds in Alberta, (Western Canada) were enrolled in this study. Cows with clinical metritis had lower serum concentrations of glutamate dehydrogenase (GLDH) at pre and postpartum and lower total Ca, albumin, urea, and cholesterol at postpartum when compared to control cows. Cows with hypocalcaemia had greater serum concentrations of Na, Cl, and calculated osmolarity (CalOsmo) at prepartum and lower concentration of total serum Ca, glucose, cholesterol, gamma-glutamyl transpeptidase (GGT), GLDH, total protein and albumin at postpartum. Prepartum serum concentrations of non-esterified fatty acids (NEFA), beta hydroxybutyrate (BHB), Cl, albumin/globulin ratio (A/G), Na, K and sum of Na and K were greater in ketotic cows when compared with control cows. Cows with ketosis had also greater postpartum serum concentrations of NEFA, BHB, GGT and aspartate transaminase (AST) when compared with control cows. Prepartum serum Na and Cl concentrations and CalOsmo were greater in cows diagnosed with hypocalcaemia or ketosis when compared with control cows. Furthermore, postpartum serum concentrations of total Ca, cholesterol, albumin and GLDH were significantly affected by hypocalcaemia or clinical metritis and concentrations of GGT by hypocalcaemia or ketosis. Finally, postpartum serum concentrations of haptoglobin increased in all disease groups when compared with control cows. These results suggest common metabolic features for clinical metritis, hypocalcaemia and ketosis in dairy cows in addition to the specific ones.


Asunto(s)
Enfermedades de los Bovinos/sangre , Endometritis/veterinaria , Hipocalcemia/veterinaria , Cetosis/veterinaria , Minerales/metabolismo , Ácido 3-Hidroxibutírico/sangre , Alberta , Animales , Aspartato Aminotransferasas/sangre , Bovinos , Colesterol/sangre , Endometritis/sangre , Ácidos Grasos no Esterificados/sangre , Femenino , Haptoglobinas/metabolismo , Hipocalcemia/sangre , Lactancia , Periodo Posparto/sangre , Estudios Retrospectivos , gamma-Glutamiltransferasa/sangre
12.
Life Sci ; 264: 118590, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33069736

RESUMEN

AIMS: Pregnancy is associated with numerous changes in physiological and metabolic processes to ensure successful progression to full term. One such change is the alteration of arachidonic acid (AA) metabolism and formation of eicosanoids. This study explores the changes in AA metabolites formed through the cytochrome P450 mediated pathway to epoxyeicosatrienoic (EET), dihydroxyeicosatrienoic (DHET), and hydroxyeicosatetraenoic (HETE) acids which have been implicated in blood pressure regulation and inflammatory responses that are important for a healthy pregnancy. MAIN METHODS: The study determines circulating levels of EETs, DHETs and HETEs extracted from erythrocyte membranes and measured by mass spectroscopy during the progression of a normal pregnancy. Blood samples, from 25 women, were collected at three time points including 25-28 weeks gestation, 28-32 weeks gestation, and the non-pregnant control at 3-4 months postpartum. KEY FINDINGS: Results demonstrate that healthy pregnancy is associated with significant increases in 8,9-DHET, 11,12-DHET and 14,15-DHET and a decrease in trans 8,9-EET during 28-32 weeks gestation compared to 3-4 months postpartum. These differences are likely due to several mechanisms including an increase in soluble epoxide hydrolase activity, a decrease in glutathione conjugation, and altered cytochrome P450 enzyme expression and/or activity that occurs during pregnancy. SIGNIFICANCE: Metabolism of AA through the cytochrome P450 pathway generates physiologically important eicosanoids that could play an important role in the progression of a healthy pregnancy. Establishing the changes that occur during normal pregnancy may, in the future, help in early detection of pregnancy complications including preeclampsia.


Asunto(s)
Membrana Eritrocítica/metabolismo , Ácidos Hidroxieicosatetraenoicos/sangre , Periodo Posparto/sangre , Segundo Trimestre del Embarazo/sangre , Tercer Trimestre del Embarazo/sangre , Adulto , Biomarcadores/sangre , Eicosanoides/sangre , Femenino , Humanos , Embarazo
13.
J Dairy Sci ; 104(2): 2243-2253, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33246622

RESUMEN

The objective of this study was to compare periparturient serum Ca dynamics (CaDyn) in cows with and without diseases in early lactation. The study enrolled 1,949 cows from a commercial dairy farm in northern Germany. Blood samples were drawn 7 d before expected calving date and on d 0, 1, 3, and 7 after calving and analyzed for serum Ca concentration. Cows were monitored for clinical hypocalcemia (CH), ketosis, left displaced abomasum (LDA), retained placenta, acute puerperal metritis (APM), mastitis, and pneumonia. To evaluate the association between CaDyn and diseases during the transition period, repeated measures ANOVA with first-order autoregressive covariance were performed. Serum CaDyn of healthy cows (i.e., without any of the aforementioned diseases) was compared with CaDyn of cows with one of the aforementioned diseases (CH, ketosis, APM, mastitis, LDA, and pneumonia), and cows with multiple diseases (CH+, ketosis+, APM+, mastitis+, LDA+, and pneumonia+). Separate models were built for primiparous and multiparous cows. For primiparous cows, we evaluated the association between CaDyn and ketosis (healthy cows vs. cows with ketosis vs. cows with ketosis+) and CaDyn and APM (healthy cows vs. cows with APM vs. cows with APM+). The same models were built for multiparous cows. Three additional models were built for multiparous cows to evaluate the association between CaDyn and CH (healthy cows vs. cows with CH vs. cows with CH+), mastitis (healthy cows vs. cows with mastitis vs. cows with mastitis+), or LDA (healthy cows vs. cows with LDA vs. cows with LDA+). In primiparous cows, serum Ca concentrations of cows with ketosis, APM, and APM+ were significantly reduced on d 3 and 7 after calving, compared with healthy cows. Serum Ca concentrations of primiparous cows with ketosis+ were reduced on d 3, but not on d 7 after calving. Multiparous cows with CH had significantly reduced serum Ca concentrations on d 0, 1, and 3 compared with healthy cows. On d 3 and 7, serum Ca concentration of CH+ cows was significantly reduced compared with healthy multiparous cows. Multiparous cows with ketosis and ketosis+ had significantly reduced serum Ca concentrations on d 1 and 3 compared with healthy cows. Cows with APM+ had significantly increased serum Ca concentrations on d 0 and reduced serum Ca concentrations on d 3, compared with healthy cows. Whereas multiparous cows with mastitis had a reduced serum Ca concentration on d 1, mastitis+ cows had a reduced serum Ca concentration on d 1 and 3, compared with healthy multiparous cows. Overall, multiparous cows with LDA+ had reduced serum Ca concentrations. Especially a delayed onset of hypocalcemia (d 3 and 7) was indicative for the development of disease in primiparous cows. In multiparous cows, reduced serum Ca concentrations on d 1 and 3 were associated with occurrence of diseases. Future studies should evaluate whether reduced serum Ca concentrations are a cause or concomitant circumstance of diseases in early lactation.


Asunto(s)
Calcio/sangre , Enfermedades de los Bovinos/sangre , Trastornos Puerperales/veterinaria , Animales , Bovinos , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/etiología , Femenino , Alemania/epidemiología , Hipocalcemia/veterinaria , Cetosis/sangre , Cetosis/veterinaria , Lactancia/sangre , Parto/sangre , Retención de la Placenta/sangre , Retención de la Placenta/veterinaria , Periodo Posparto/sangre , Embarazo , Trastornos Puerperales/sangre , Trastornos Puerperales/epidemiología , Enfermedades Uterinas/veterinaria
14.
Int J Lab Hematol ; 43(4): 609-615, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33347714

RESUMEN

INTRODUCTION: Bacteraemia in pregnancy and the post-partum period can lead to maternal and newborn morbidly. The purpose of this study was to use machine learning tools to identify if bacteraemia in pregnant or post-partum women could be predicted by full blood count (FBC) parameters other than the white cell count. METHODS: The study was performed on 129 women with a positive blood culture (BC) for a clinically significant organism, who had a FBC taken at the same time. They were matched with controls who had a negative BC taken at the same time as a FBC. The data were split in to a training (70%) and test (30%) data set. Machine learning techniques such as recursive partitioning and classification and regression trees were used. RESULTS: A neutrophil/lymphocyte ratio (NLR) of >20 was found to be the most clinically relevant and interpretable construct of the FBC result to predict bacteraemia. The diagnostic accuracy of NLR >20 to predict bacteraemia was then examined. Thirty-six of the 129 bacteraemia patients had a NLR >20, while only 223 of the 3830 controls had a NLR >20. This gave a sensitivity of 27.9% (95% CI 20.3-36.4), specificity of 94.1% (93.3-94.8), positive predictive value of 13.9% (10.6-17.9) and a negative predictive value (NPV) of 97.4% (97.2-97.7) when the prevalence of bacteraemia was 3%. CONCLUSION: The NLR should be considered for use in routine clinical practice when assessing the FBC result in patients with suspected bacteraemia during pregnancy or in the post-partum period.


Asunto(s)
Bacteriemia/sangre , Periodo Posparto/sangre , Complicaciones Infecciosas del Embarazo/sangre , Recuento de Células Sanguíneas , Femenino , Humanos , Recién Nacido , Embarazo , Estudios Retrospectivos
15.
BMC Vet Res ; 16(1): 470, 2020 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-33267889

RESUMEN

BACKGROUND: Left displaced abomasum (LDA) occurs at high frequency in the early postpartum period and can affect production performance of dairy cows. Clinical diagnosis of LDA is usually done by abdominal auscultation and percussion. The purpose of this study was to explore the potential applicability of blood biomarkers for early warning and diagnosis of LDA in dairy cows. RESULTS: Twenty early postpartum healthy cows and thirty early postpartum LDA cows of similar parity were used. A receiver operating characteristic curve (ROC) method was used to analyze the sensitivity of hematological biomarkers to LDA including energy balance metabolic biomarkers, liver/kidney function biomarkers, and minerals. A cut-off point was defined for each of the selected hematological biomarkers deemed sensitive markers of LDA. Compared with healthy cows, body condition score (BCS), dry matter intake (DMI) and milk production were lower in LDA cows. Among energy metabolism markers, serum non-esterified fatty acid (NEFA), ß-hydroxybutyric acid (BHBA), insulin (INS), and revised quantitative insulin sensitivity check index (RQUICKI) levels were lower while serum glucagon (GC) was greater in LDA cows. Among the liver/kidney function biomarkers, activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), the ratio of AST/ALT and levels of total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), albumin (ALB), blood urea nitrogen (BUN), creatinine, and total protein (TP) were greater in LDA cows. Among minerals analyzed, serum Cl, Ca, and K were lower in LDA cows. After ROC analysis, it was determined that serum Ca, INS, RQUICKI, ALT, GGT, and creatinine are potential indicators for early warning and diagnosis of LDA for early postpartum dairy cows. CONCLUSIONS: Dairy cows with LDA were under severe negative energy balance (NEB), had signs of liver damage and potentially lower insulin sensitivity. A combination of multi-hematological biomarkers including Ca, INS, RQUICKI, ALT, GGT and creatinine has the potential to help identify cows at risk of LDA in the early postpartum period.


Asunto(s)
Abomaso , Biomarcadores/sangre , Enfermedades de los Bovinos/diagnóstico , Gastropatías/veterinaria , Alanina Transaminasa/sangre , Animales , Calcio/sangre , Bovinos , Enfermedades de los Bovinos/sangre , Creatinina/sangre , Industria Lechera , Femenino , Insulina/sangre , Periodo Posparto/sangre , Gastropatías/sangre , Gastropatías/diagnóstico , gamma-Glutamiltransferasa/sangre
16.
Nutr Metab Cardiovasc Dis ; 30(12): 2389-2397, 2020 11 27.
Artículo en Inglés | MEDLINE | ID: mdl-33239164

RESUMEN

BACKGROUND AND AIM: The relationship among distribution of pathological values at the Oral Glucose Tolerance Test (OGTT), metabolic risk factors and pregnancy outcomes in women with Gestational Diabetes (GDM), has not been clearly identified. We retrospectively compared metabolic and therapeutic parameters, maternal-fetal outcomes and post-partum OGTTs, with respect to the number and distribution of altered values of diagnostic OGTT in pregnancy. Secondly, we assessed whether insulin therapy predictive factors were identifiable. METHODS AND RESULTS: This analysis included 602 pregnant women with GDM, followed in Diabetes and Pregnancy Unit of Perugia Hospital from diagnosis to childbirth. All women were diagnosed diabetic upon 75g OGTT, according IADPSG criteria. Women were divided into 3 groups, respect to distribution of diagnostic blood glucose (BG) values at OGTT: Group 1: only fasting BG (OGTT0h); Group 2: 1 and/or 2h (OGTT1-2h); Group 3: both fasting and 1 h and/or 2h (OGTT0+1-2h) BG. Pregnant women with fasting hyperglycemia at OGTT (Groups 1 and 3) had similar metabolic characteristics (weight, prevalence of obesity, gestational weight gain, HbA1c), a greater need for insulin therapy, and a higher risk of impaired glucose tolerance persistence after childbirth, as compared to Group 2. No significant differences were observed in terms of maternal and neonatal outcomes (p > 0.05), except for a greater prevalence of caesarean sections in Group 3. CONCLUSION: The metabolic characteristics of GDM women are mirrored by OGTT values at diagnosis, but are not associated with adverse pregnancy outcomes. Intensive management and a tailored treatment of GDM improve maternal-neonatal outcomes, regardless of diagnostic values distribution and pre-gestational metabolic characteristics.


Asunto(s)
Glucemia/metabolismo , Diabetes Gestacional/diagnóstico , Prueba de Tolerancia a la Glucosa , Periodo Posparto/sangre , Adulto , Biomarcadores/sangre , Cesárea , Diabetes Gestacional/sangre , Diabetes Gestacional/tratamiento farmacológico , Diabetes Gestacional/fisiopatología , Ayuno/sangre , Femenino , Hemoglobina A Glucada/metabolismo , Humanos , Insulina/uso terapéutico , Nacimiento Vivo , Valor Predictivo de las Pruebas , Embarazo , Estudios Retrospectivos
17.
J Dairy Sci ; 103(12): 11782-11794, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33222861

RESUMEN

The objective of the present study was to assess the association of prepartum lying time (LT) and the coefficient of variation (CV) of LT within 7 d before calving with prepartum serum nonesterified fatty acid (NEFA) concentration at 7 ± 3 d prepartum (dpp) and stillbirth. Prepartum pregnant Holstein heifers and cows from 3 dairy herds were used (n = 1,044). Animals were housed in freestall barns using a prepartum pen 21 d before the expected calving date and were moved into a contiguous maternity pen at parturition. Monthly, cohorts of 20 to 36 animals (heifers and cows combined) were enrolled at each farm and electronic data loggers (IceQube, IceRobotics, Edinburgh, UK) were fitted to the hind leg of individual animals to assess their behavioral activity. Stillbirth was defined as a calf born dead or died during the first 24 h after parturition in dams with normal gestation length. The LT was recorded for the last 7 dpp to assess differences among dams with stillbirth versus those with a calf born alive. Mean LT within 7 d before blood NEFA collection was assessed to determine the association with prepartum serum NEFA at 7 ± 3 dpp. Blood samples for the assessment of serum NEFA concentration were collected from prepartum animals at 14 ± 3 and at 7 ± 3 dpp. Blood samples for total serum calcium concentration were collected from postpartum cows within 48 h after parturition to assess differences among cows with stillbirth versus those with a calf born alive. Data were analyzed using CORR, MIXED, or GLIMMIX procedures of SAS (SAS Institute Inc., Cary, NC). Dams experiencing dystocic births had a greater proportion of stillbirth, but herd, parity, and season did not have an effect. Dams with a stillborn calf had reduced LT and increased CV of LT within the last 7 dpp compared with dams with a calf born alive, regardless of parity. Multiparous cows with a stillborn calf had higher prepartum serum NEFA concentration compared with multiparous cows with a calf born alive, but this did not differ for first-calf heifers. Regardless of parity, the proportion of postpartum cows with hypocalcemia was higher for dams with a stillborn calf compared with those with a calf born alive. Regardless of parity, LT of prepartum dams was strongly correlated with the CV of LT (as LT increased, the CV decreased), and prepartum dams with a mean LT between 11 and 15 h/d had the lowest serum NEFA concentration compared with dams with LT of 8 to 10 or >16 h/d. Serum NEFA concentrations at 7 ± 3 dpp was positively correlated with the CV of LT within 7 d before blood sample. These results show that the dam's prepartum LT and its consistency over time are associated with prepartum serum NEFA and calf survival at calving.


Asunto(s)
Enfermedades de los Bovinos/sangre , Ácidos Grasos no Esterificados/sangre , Periodo Posparto/sangre , Descanso , Mortinato/veterinaria , Animales , Bovinos , Femenino , Lactancia , Paridad , Parto , Embarazo , Estudios Prospectivos , Estaciones del Año
18.
PLoS One ; 15(10): e0239720, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33017436

RESUMEN

BACKGROUND: Women with hyperglycaemia first detected in pregnancy (HFDP), including those with gestational diabetes mellitus (GDM), should undergo a glucose evaluation 4-12 weeks after delivery. Globally, suboptimal postpartum return rates limit the opportunity to intervene in women with sustained hyperglycaemia and pragmatic solutions should be sought to bridge this gap. OBJECTIVE: To assess the utility of postpartum in-hospital glucose evaluation to predict the outcome of the oral glucose tolerance test (OGTT) performed 4-12 weeks after delivery. METHODS: The study was performed prospectively at Tygerberg Hospital, Cape Town, South Africa. Women with HFDP, classified as GDM based on the modified National Institute for Health and Care Excellence criteria, who delivered between November 2018 and June 2019 were included in the study. Fasting plasma glucose (FPG) was performed 24-72 hours after delivery (t1) in the postnatal ward, provided glucose lowering medication was discontinued at delivery. An OGTT 4-12 weeks postpartum (t2) was scheduled for the total cohort. We compared glucose values and glucose categories at t1 and t2 and evaluated antenatal characteristics of women who returned, compared to the group that was lost to follow-up. RESULTS: In-hospital post-delivery glucose assessment (t1) was performed in 115 women. Glucose levels were significantly lower at t1 compared to antenatal diagnostic values (t0) and assessment at t2. Of the fourteen women with hyperglycaemia at t2, none had abnormal fasting glucose concentrations at t1. Women with HFDP who fulfilled criteria for overt diabetes at t0, all (24/115) had normal fasting glucose levels at t1 except for IFG in one (1/24). The antenatal characteristics of women with HFDP who returned at t2, were similar to the women who did not return. CONCLUSION: Based on this study, in-hospital fasting glucose 24-72 hours postpartum cannot replace the OGTT 4-12 weeks postpartum. Pragmatic solutions for low postpartum return rates in women with HFDP should be pursued.


Asunto(s)
Glucemia/análisis , Glucosa/metabolismo , Hiperglucemia/fisiopatología , Adulto , Estudios de Cohortes , Diabetes Mellitus Tipo 2/sangre , Diabetes Gestacional/sangre , Ayuno/sangre , Ayuno/fisiología , Femenino , Intolerancia a la Glucosa/sangre , Prueba de Tolerancia a la Glucosa , Humanos , Periodo Posparto/sangre , Embarazo , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Sudáfrica
19.
Prev Vet Med ; 185: 105180, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33129021

RESUMEN

This study aimed to evaluate the effects of oral administration of calcium (Ca) formate in the postpartum of high-producing dairy cows on calcemia, on other blood biochemical markers, and on the occurrence of diseases at the beginning of lactation. One hundred and twenty healthy Holstein cows, distributed according to the lactation order (first, second, third and fourth to sixth), were treated or not with oral Ca formate (two doses: one after calving and one 24 h later; equivalent to 50 g of Ca per dose), comprising 8 groups (n = 15). The following variables were measured in the blood serum of samples collected after calving (0 h) and after 24, 48, 72, and 96 h: total Ca, phosphate (P), magnesium (Mg), non-esterified fatty acids (NEFA), beta-hydroxybutyrate (BHB), glucose, total protein (TP), albumin (Alb), urea nitrogen (BUN), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT). Blood BHB was also measured at 7, 14, and 21 DIM. For the assessment of disease occurrence, cows were distributed in treated (n = 60) and untreated (n = 60) groups and in hypocalcemic (n = 71) and normocalcemic (n = 49) groups. Two-way repeated measures ANOVA and a chi-square test were used for comparisons. The lactation order did not influence the studied blood constituents, except for primiparous cows which had the highest calcemia. Serum Ca was lower up to 24 h and increased after 48 h and subclinical hypocalcemia (SCH) ([Ca] < 2.125 mmol/L) was more frequent in cows with a higher number of lactations. Treatment with Ca formate had no effect on the variation of serum Ca and the other studied variables in the first days of lactation. Treated and untreated cows did not differ in terms of milk yield at 21 DIM, the presentation of diseases at the beginning of lactation, the rate of discard or death up to 60 DIM and the frequency of SCH (60 % and 58 %, respectively). Hypocalcemic cows became more ill (64.8 % vs. 42.9 %; P = 0.028) and had a higher frequency of retained placenta (43 % vs. 20.7 %; P < 0.001). Oral administration of Ca formate after calving and 24 h later is not justified as a preventive measure to be adopted indiscriminately in dairy herds. Studies involving larger number of animals may clarify whether the selective treatment of cows with a higher risk of hypocalcemia is advantageous.


Asunto(s)
Calcio/administración & dosificación , Enfermedades de los Bovinos/tratamiento farmacológico , Hipocalcemia/veterinaria , Lactancia , Periodo Posparto , Administración Oral , Animales , Infecciones Asintomáticas , Sangre/metabolismo , Análisis Químico de la Sangre/veterinaria , Brasil , Calcio/sangre , Bovinos , Femenino , Hipocalcemia/tratamiento farmacológico , Periodo Posparto/sangre
20.
Open Heart ; 7(2)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33077550

RESUMEN

OBJECTIVE: To describe the intraindividual changes of heart biomarker levels during and after pregnancy and to evaluate existing cut-off levels for heart failure or myocardial ischaemia in pregnant women. METHOD: A total of 196 healthy pregnant women were recruited from maternal outpatient clinics and included in the study. Blood samples were obtained on four occasions: at 10-12 gestational weeks (gw), 20-25 gw, after delivery and 6 months postpartum and analysed for N-terminal pro-brain natriuretic peptide (NTproBNP) and high sensitive cardiac troponin T (hs-cTNT). Echocardiography ruled out existing cardiac disease. Estimated glomerular filtration rate (eGFR) was calculated. RESULTS: There were significant changes in NTproBNP between the measurements with the highest NTproBNP at 10-12 gw and the lowest value being at 20-25 gw, (with eGFR being the highest). Hs-cTNT was significantly higher at the peripartum measurement compared with the other measurements (p<0.05). Regardless, the 95th percentile for both biomarkers was below cut-off levels of 300 ng/L for NTproBNP and 14 ng/L for hs-cTNT. There was an association between NTproBNP above the upper limit of normal of 125 ng/L and eGFR (p=0.04) and between hs-cTNT >5.0 ng/L and time from delivery to blood sample (p=0.001) at the peripartum measurement. Both were associated with the use of oxytocin. CONCLUSION: Existing cut-off values for ruling out heart failure (NTproBNP <300 ng/L) and myocardial ischaemia (hs-cTNT <14 ng/L) are applicable during pregnancy and after delivery. Elevated levels mandate further attention on cardiac symptoms and renal function.


Asunto(s)
Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Troponina T/sangre , Adulto , Biomarcadores/sangre , Femenino , Edad Gestacional , Voluntarios Sanos , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/diagnóstico , Humanos , Isquemia Miocárdica/sangre , Isquemia Miocárdica/diagnóstico , Periodo Posparto/sangre , Valor Predictivo de las Pruebas , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Estudios Prospectivos , Factores de Tiempo
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