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Medicine (Baltimore) ; 99(1): e18673, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895835

RESUMO

The documents on the median effective concentration of local analgesic were many in primiparas during labor analgesia. However, the studies were fewer in multiparas. To explore the analgesic requirements in multiparas during epidural labor analgesia, we investigated the median effective concentration of ropivacaine with 2 µg/mL fentanyl for epidural labor analgesia in multiparas.Sixty-two women were recruited and assigned to the primipara group and multipara group in this prospective study. All the parturients received ropivacaine combined with 2 µg/mL fentanyl for epidural labor analgesia. The concentration of ropivacaine was determined by the up and down method and an initial concentration was set as 0.1% with a 0.01% interval. Effective analgesia was defined as the visual analog scale (VAS) ≤3 within 30 minutes after epidural administration when cervical dilatation is about 2 cm. The median effective concentration of ropivacaine was calculated by the up and down sequential method. The pain intensity was assessed using VAS. Hemodynamic parameters, the labor stages, and neonatal Apgar scores were recorded. Umbilical artery blood was drawn to analyze. The side effects, if any, were also recorded.The median effective concentration of ropivacaine was 0.057% (95% confidence interval [CI], 0.051-0.064%) in primiparas during epidural labor analgesia, and 0.068% (95% CI, 0.063-0.072%) in multiparas during epidural labor analgesia, there was significant difference between the groups (P = .02).This study indicated that the median effective concentration of ropivacaine with fentanyl for epidural labor analgesia was 0.068% (95% CI, 0.063-0.072%) and increased in multiparas compared with the primiparas (www.chictr.org.cn, registration number: ChiCTR-1800016486).


Assuntos
Analgesia Epidural , Analgesia Obstétrica , Anestésicos Locais/administração & dosagem , Paridade , Ropivacaina/administração & dosagem , Adulto , Feminino , Humanos , Gravidez
3.
BJOG ; 127(3): 397-403, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31749273

RESUMO

OBJECTIVE: To determine whether restrictive or routine episiotomy in term pregnant Southeast Asian women results in fewer complications. DESIGN: A multicentre randomised controlled trial. SETTING: Two tertiary and two general hospitals in Thailand. POPULATION: 3006 singleton pregnant women 18 years or older, ≥37 weeks of gestation, cephalic presentation and planned vaginal delivery. METHODS: This randomised controlled trial compared routine versus restrictive episiotomies in Thai women giving birth vaginally. Participants were singleton, term pregnant women with cephalic presentation. Block randomisation was stratified by study site and parity. Risk ratios (RR) and 95% confidence intervals (CI) were calculated to indicate between-group differences. MAIN OUTCOME MEASURES: Primary outcome was severe perineal laceration. Secondary outcomes included vaginal laceration, cervical laceration, and pregnancy outcomes. RESULTS: 3006 women were randomly assigned to restrictive (1502) and routine (1504) episiotomy. There was no difference in severe perineal laceration between the groups (RR 0.72, 95% CI 0.46-1.12). Restrictive episiotomy resulted in more intact perineums in multiparous women (RR 3.09, 95% CI 2.10-4.56). Restrictive episiotomy increased the risk of vaginal laceration in primiparous (RR 1.96, 95% CI 1.62-2.37) and multiparous women (RR 2.21, 95% CI 1.77-2.75) but did not lead to more suturing. There were comparable risks of cervical laceration, postpartum haemorrhage, wound complication, birth asphyxia, and admission to neonatal intensive care unit. CONCLUSIONS: Restrictive episiotomy results in more intact perineum in multiparous women. Risks of maternal and neonatal outcomes were comparable between the two practices. These results strengthen the certainty of the existing Cochrane review findings in supporting restrictive episiotomy. TWEETABLE ABSTRACT: Restrictive episiotomy results in more intact perineums after vaginal birth in multiparous Southeast Asian women.


Assuntos
Parto Obstétrico , Episiotomia , Complicações Intraoperatórias , Lacerações , Períneo/lesões , Adulto , Parto Obstétrico/efeitos adversos , Parto Obstétrico/métodos , Episiotomia/efeitos adversos , Episiotomia/métodos , Feminino , Humanos , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/prevenção & controle , Apresentação no Trabalho de Parto , Lacerações/diagnóstico , Lacerações/etiologia , Lacerações/prevenção & controle , Paridade , Gravidez , Resultado da Gravidez/epidemiologia , Risco Ajustado/métodos , Nascimento a Termo , Tailândia
4.
BJOG ; 127(3): 345-354, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31749274

RESUMO

OBJECTIVES: To describe the population of women having bariatric surgery and compare the pregnancy outcomes for women having bariatric surgery with a non-bariatric surgery population having a first and second pregnancy. DESIGN: Population-based record linkage study. SETTING: New South Wales (NSW), Australia. POPULATION: All women aged 15-45 years with a hospital record in NSW (2002-2014) and all women giving birth in NSW (1994-2015; n = 1 606 737 women). METHODS: Pregnancy and birth outcomes were compared between first and second pregnancies using repeated-measures logistic regression and paired Student's t-tests. Bariatric and non-bariatric groups were also compared. MAIN OUTCOME MEASURES: Maternal diabetes, preterm birth (<37 weeks of gestation) and large for gestational age. RESULTS: There was a 13-fold increase in hospitalisations for primary bariatric surgery during 2002-2014. Compared with the general birthing population, women who had bariatric surgery experienced higher rates of hypertension, diabetes, and preterm birth. Among women who had bariatric surgery between a first and second pregnancy, there were reduced rates of hypertension (OR 0.39, 95% CI 0.29-0.53), spontaneous preterm birth (OR 0.37, 95% CI 0.16-0.86), infants that were large for gestational age (OR 0.63, 95% CI 0.44-0.88), and the admission of infants to a special care nursery or neonatal intensive care (OR 0.64, 95% CI 0.46-0.90) in the second pregnancy. Rates for small-for-gestational age and gestational diabetes following surgery were 8.3 and 11.4%, respectively CONCLUSIONS: Bariatric surgery between a first and second pregnancy was associated with reductions in obesity-related adverse pregnancy outcomes. Bariatric surgery performed for the management of obesity in accordance with current clinical criteria is associated with improved pregnancy outcomes in a subsequent pregnancy. TWEETABLE ABSTRACT: Bariatric surgery for obesity may improve pregnancy and birth outcomes in a subsequent pregnancy.


Assuntos
Cirurgia Bariátrica , Diabetes Gestacional , Obesidade , Nascimento Prematuro/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adulto , Austrália/epidemiologia , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/estatística & dados numéricos , Peso ao Nascer , Cesárea/estatística & dados numéricos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Recém-Nascido , Armazenamento e Recuperação da Informação , Obesidade/epidemiologia , Obesidade/cirurgia , Paridade , Gravidez , Resultado da Gravidez/epidemiologia
5.
BJOG ; 127(1): 70-78, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31571337

RESUMO

OBJECTIVE: To investigate preterm birth (PTB) phenotypes in women with different autoimmune rheumatic diseases in a large population-based cohort. DESIGN: Retrospective cohort study. SETTING: California, USA. POPULATION: All live singleton births in California between 2007 and 2011 were analysed. Patients with autoimmune disease at delivery were identified by International Classification of Diseases, Ninth Revision , Clinical Modification (ICD-9-CM), codes for systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), polymyositis/dermatomyositis (DM/PM), and juvenile idiopathic arthritis (JIA). METHODS: Maternally linked hospital and birth certificate records of 2 481 516 deliveries were assessed (SLE n = 2272, RA n = 1501, SSc n = 88, JIA n = 187, DM/PM n = 38). Multivariable Poisson regression models estimated the risk ratios (RRs) for different PTB phenotypes (relative to term deliveries) for each autoimmune disease compared with the general obstetric population, adjusting for maternal age, race/ethnicity, body mass index, smoking, education, payer, parity, and prenatal care. MAIN OUTCOME MEASURES: Preterm birth (PTB) was assessed overall (20-36 weeks of gestation) and by subphenotype: preterm prelabour rupture of membranes (PPROM), spontaneous birth, or medically indicated PTB. The risk of PTB overall and for each phenotype was partitioned by gestational age: early (20-31 weeks of gestation) and late (32-36 weeks of gestation). RESULTS: Risks for PTB were elevated for each autoimmune disease evaluated: SLE (RR 3.27, 95% CI 3.01-3.56), RA (RR 2.04, 95% CI 1.79-2.33), SSc (RR 3.74, 95% CI 2.51-5.58), JIA (RR 2.23, 95% CI 1.54-3.23), and DM/PM (RR 5.26, 95% CI 3.12-8.89). These elevated risks were observed for the majority of PTB phenotypes as well. CONCLUSIONS: Women with systemic autoimmune diseases appear to have an elevated risk of various PTB phenotypes. Therefore, preconception counselling and close monitoring during pregnancy is crucial. TWEETABLE ABSTRACT: This study found that women with systemic autoimmune diseases have an elevated risk of preterm birth phenotypes.


Assuntos
Doenças Autoimunes/epidemiologia , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Doenças Reumáticas/epidemiologia , Adulto , California/epidemiologia , Feminino , Idade Gestacional , Humanos , Paridade , Fenótipo , Pré-Eclâmpsia/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco
6.
BJOG ; 127(1): 47-56, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31512355

RESUMO

OBJECTIVE: To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). DESIGN: Prospective population-based study. SETTING: Hospital-based maternity units throughout A&NZ. POPULATION: Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014. METHODS: We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed. MAIN OUTCOME MEASURES: Prevalence of RHD in pregnancy. Perinatal morbidity and mortality. RESULTS: There were 311 pregnancies associated with women with RHD (4.3/10 000 women giving birth, 95% CI 3.9-4.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4/10 000, 95% CI 50.7-70.0), while in New Zealand 90% were Maori or Pasifika (27.2/10 000, 95% CI 22.0-32.3). One woman (0.3%) died and one in ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3/1000 births) and two neonatal deaths (6.5/1000 births). Sixty-six (21%) live-born babies were preterm and one in three was admitted to neonatal intensive care or special care units. CONCLUSION: Rheumatic heart disease in pregnancy persists in disadvantaged First Nations populations in A&NZ. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and RHD screening in at-risk pregnant women are essential for good maternal and baby outcomes. TWEETABLE ABSTRACT: Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.


Assuntos
Complicações Cardiovasculares na Gravidez/etnologia , Cardiopatia Reumática/etnologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Renda , Nova Zelândia/epidemiologia , Nova Zelândia/etnologia , Northern Territory/epidemiologia , Northern Territory/etnologia , Grupo com Ancestrais Oceânicos/etnologia , Paridade , Gravidez , Prevalência , Estudos Prospectivos , Adulto Jovem
7.
Int Braz J Urol ; 46(1): 5-14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31851453

RESUMO

The exact prevalence of pelvic organ prolapse is difficult to establish. The anatomical changes do not always consist with the severity or the symptoms associated with prolapse. There are many risk factors associated with pelvic organ prolapse and this review aims to identify the epidemiology and pathophysiology while looking at the known risk factors for pelvic organ prolapse. PubMed search involved a number of terms including: epidemiology, risk factors, reoccurrence indicators, management and evaluation. Several risk factors have been associated with pelvic organ prolapse, all contribute to weakening of the pelvic floor connective tissue/collagen, allowing the pelvic organs to prolapse through the vaginal walls. Among the risk factors are genetic background, childbirth and mode of delivery, previous hysterectomy, menopausal state and the ratio between Estrogen receptors. The "Integral theory" of Petros and the "Levels of Support" model of Delancey enable us to locate the defect, diagnose and treat pelvic organ prolapse. The currently available demographic data is not reliable enough to properly estimate the true extent of pelvic organ prolapse in the population. However, standardization of the diagnosis and treatment may significantly improve our ability to estimate the true incidence and prevalence of this condition in the coming years.


Assuntos
Prolapso de Órgão Pélvico/etiologia , Prolapso de Órgão Pélvico/fisiopatologia , Colágeno/fisiologia , Feminino , Humanos , Menopausa/fisiologia , Obesidade/complicações , Obesidade/fisiopatologia , Paridade , Diafragma da Pelve/fisiopatologia , Prolapso de Órgão Pélvico/terapia , Fatores de Risco
8.
Niger J Clin Pract ; 22(12): 1635-1643, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31793468

RESUMO

Background: Prenatal distress and fear of childbirth negatively affect the health of the mother and the fetus. Sociodemographic and pregnancy related characteristics may influence prenatal distress and fear of childbirth. Aim: This study aimed to explore the relationship between fear of childbirth and prenatal distress levels with accompanying factors. Subjects and Methods: The study was designed as a cross-sectional survey study and conducted in the outpatient clinic of Obstetrics and Gynecology Department of Pamukkale University Hospital, Denizli, Turkey, between April 2017 and January 2018. Survey data were collected from 103 third-trimester pregnant women who had admitted to the hospital for routine prenatal examination. Sociodemographic Information Form, the Revised Prenatal Distress Questionnaire (NUPDQ), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) were used to collect data. Sociodemographics, obstetrics, and other variables were summarized by descriptive statistics. Mann-Whitney U-test, Chi-squared test, and Fisher's exact test were used for comparison of data between groups. Results: The mean score of NUPDQ was 7.58 (SD 4.09) in the nulliparous group and 8.17 (SD 5.16) in the multiparous group (P = 0.68). The mean W-DEQ score was 40.46 (SD 21.80) in nulliparous women and 45.55 (SD 26.72) in multiparous women (P = 0.38). The W-DEQ and NUPDQ scores were moderately correlated with a Spearman correlation co-efficient of 0.58 (P < 0.001). Conclusions: The results of this study revealed that fear of childbirth and prenatal distress were moderately and positively correlated. NUPDQ and W-DEQ can be used during pregnancy to understand if pregnant women have fear or distress. This could help to give a better support to pregnant women.


Assuntos
Ansiedade/psicologia , Parto Obstétrico/psicologia , Medo/psicologia , Parto/psicologia , Gestantes/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Paridade , Gravidez , Cuidado Pré-Natal , Estresse Psicológico , Inquéritos e Questionários , Turquia , Adulto Jovem
9.
Medicine (Baltimore) ; 98(51): e18315, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860982

RESUMO

The incidence of breast cancer among Japanese women is substantially increasing. This study evaluated the effects of reproductive and lifestyle factors with respect to breast cancer overall and separately among pre- and postmenopausal women using data from the Three-Prefecture Cohort Study of Japan.A total of 33,410 women aged 40 to 79 years completed a self-administered questionnaire, which included items about menstrual and reproductive history and other lifestyle factors. The follow-up period was from 1984 to 1992 in Miyagi and 1985 to 2000 in Aichi Prefectures. We used Cox proportional hazards regression models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors.After 9.8 mean years of follow-up, 287 cases of breast cancer were recorded. In the overall analysis, later menarche (≥16 years) and parity were significantly associated with a decreased risk of breast cancer, with HRs of 0.69 (95% CI 0.48-0.99) and 0.72 (95% CI 0.52-0.99), respectively. Further, there was a significant decline in the risk of breast cancer with increasing number of birth among parous women (P for trend = .010). On the contrary, a family history of breast cancer in the mother was significantly associated with an increased risk of breast cancer (HR 3.22, 95% CI 1.52-6.84). Analyses based on menopausal status at baseline indicated that height (≥160 cm) and weight (≥65 kg) were significantly associated with an increased risk of postmenopausal breast cancer, with HRs of 1.34 (95% CI 0.72-2.50) and 3.13 (95% CI 1.75-5.60), respectively. Risk associated with BMI significantly differs by menopausal status.Our findings suggest the important role of reproductive factors in the development of breast cancer in Japanese women; however, body mass index (BMI) may have different effects on breast cancer in Japanese women compared with western women.


Assuntos
Neoplasias da Mama/etiologia , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Estudos de Coortes , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Anamnese , Menarca , Pessoa de Meia-Idade , Paridade , Fatores de Risco , Inquéritos e Questionários
10.
Afr Health Sci ; 19(2): 1924-1929, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656475

RESUMO

Background: Neanatal comploications are the commonest problems facing babies in Tanzania. An attempt has been made to investigate determinants of neonatal outcomes among postnatal women. Methods: Using a case-contrrol study design, 165 women were selected from 3 health facilities, where they had had antenatal care (ANC), labour, delivery and post natal care. Results: Chi- square test revealed that gestational age (p-value, 0.01), HIV status (p-value, 0.000) and malaria (p-value, 0.001<0.05) were significantly associated with adverse neonatal outcomes. Conclusion: The study concluded that implementation of community-based intervention is needed to ensure survival of newborns.


Assuntos
Infecções por HIV/epidemiologia , Complicações na Gravidez/epidemiologia , Natimorto/epidemiologia , Adolescente , Adulto , Anemia/epidemiologia , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Lactente , Mortalidade Infantil , Transmissão Vertical de Doença Infecciosa , Malária/epidemiologia , Idade Materna , Paridade , Cuidado Pós-Natal/organização & administração , Gravidez , Adulto Jovem
11.
J Anim Sci ; 97(11): 4548-4556, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31603198

RESUMO

The objectives of the current study were to explore the effects of mannan oligosaccharide (MOS) supplementation in the diets of sow and (or) their offspring on intestinal bacteria, intestinal and systemic inflammation in the piglet. A total of 60 multiparous sows (4 ± 1 parity; Landrace × Yorkshire) were fed either control diet (sCON, n = 30) or a diet containing 400 mg kg-1 MOS (sMOS, n = 30) from day 86 of gestation until weaning (day 20 of postpartum). On day 7 of age, offspring (Duroc × Landrace Yorkshire) were assigned within sow treatments and fed control diet (pCON) or diet containing 800 mg kg-1 MOS (pMOS) for 28 d (end at 35 d of age), resulting in four piglet diet groups (n = 15 litters per diet group): sCON-pCON, sCON-pMOS, sMOS-pCON, and sMOS-pMOS. Results found that piglet diet MOS increased or tend to increase Lactobacillus amount in the ileum digesta (P < 0.01) and jejunum digesta (P = 0.07), respectively; while tend to decrease Escherichia coli amount in jejunum digesta (P =0.06) and cecum digesta (P = 0.08). Both sow and piglet diets add MOS (sMOS-pMOS) increased Lactobacillus amount but decreased E. coli amount in jejunum digesta (P < 0.05) compared with the sCON-pCON diet group. In addition, sow diet MOS (rather than piglet diet MOS) increased sIgA content in piglet jejunum mucosa compared with control (P = 0.04). Sow diet MOS decreased toll-like receptor 2 (TLR2), toll-like receptor 4 (TLR4), and interleukin 8 (IL-8) mRNA levels (P < 0.05) and tended to decrease nuclear factor-κB p65 (NF-κB p65) mRNA level (P = 0.07) in piglet intestinal lymphatic. The interaction effects between sow and piglet diets were found on the mRNA levels of NF- κB p65 (P = 0.03) and IL-8 (P = 0.02) in piglet jejunum. Finally, the sow diet MOS decreased proinflammatory cytokines IL-2 (P < 0.01) and IL-4 (P < 0.01) concentrations in piglet serum. Piglets diet MOS decreased the contents of IL-2 (P = 0.03), IL-4 (P = 0.01) and interferon (IFN)-γ (P < 0.01) while increased anti-inflammatory cytokine IL-10 (P < 0.01) content in serum. The interaction effects between sows and piglet diets on IL-4 (P = 0.02), IL-10 (P < 0.01), and IFN-γ (P = 0.08) were observed. In conclusion, sow and/or piglet diet MOS could improve intestinal microbiota, enhance intestinal mucosal immune competence, and suppress intestinal and systemic inflammation in the piglet.


Assuntos
Suplementos Nutricionais/análise , Microbioma Gastrointestinal/efeitos dos fármacos , Mananas/administração & dosagem , Oligossacarídeos/administração & dosagem , Suínos/fisiologia , Ração Animal/análise , Animais , Animais Recém-Nascidos , Dieta/veterinária , Feminino , Inflamação/veterinária , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/imunologia , Masculino , Paridade , Gravidez , Suínos/imunologia
12.
BMC Vet Res ; 15(1): 346, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619239

RESUMO

BACKGROUND: Lameness in dairy cows has been an ongoing concern of great relevance to animal welfare and productivity in modern dairy production. Many studies have examined associations between various factors related to housing, management, and the individual animal and the occurrence of lameness. The objective of this systematic review was to answer the research question "what are risk factors associated with lameness in dairy cows that are housed in free stall barns or tie stall facilities". Furthermore, we performed a synthesis of current evidence on certain risk factors by means of a meta-analysis to illustrate the strength of their association with bovine lameness. RESULTS: Following pre-defined procedures and inclusion criteria in accordance with the PRISMA statement, two observers independently included 53 articles out of a pool of 1941 articles which had been retrieved by a broad literature research in a first step. 128 factors that have been associated with lameness were identified in those papers. Meta-analyses were conducted for five factors presented in six different studies: Body condition score, presence of claw overgrowth, days in milk, herd size, and parity. Results indicated that a body condition score of ≤2.5/5 is associated with increased odds of lameness. A higher risk of being lame was found for the presence of claw overgrowth, the first 120 days in milk, larger herd sizes, and increasing parity. Throughout the study, we encountered profound difficulties in retrieving data and information of sufficient quality from primary articles as well as in recovering comparable studies. CONCLUSIONS: We learned that an abundance of literature on bovine lameness exists. To adequately address a problem of this importance to both animal welfare and economic viability, solid evidence is required in the future to develop effective intervention strategies. Therefore, a consistent working definition of lameness and specific risk factors should be an option to consider.


Assuntos
Doenças dos Bovinos/epidemiologia , Coxeadura Animal/epidemiologia , Animais , Composição Corporal , Bovinos , Indústria de Laticínios/métodos , Feminino , Casco e Garras , Lactação , Paridade , Fatores de Risco
13.
BMC Womens Health ; 19(1): 117, 2019 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-31590639

RESUMO

BACKGROUND: Women with a higher number of pregnancies have a higher risk of developing cardiovascular diseases. Subtle fluctuations in albumin excretion could be related to pathophysiologic changes in the vascular system. We aimed to investigate the possible association of parity with low-grade albuminuria. METHODS: We conducted a community-based study in 6495 women aged 40 years or older. Low-grade albuminuria was defined according to the highest quartile of urine albumin-to-creatinine ratio in participants free of micro- or macro-albuminuria. RESULTS: Parous women with a higher number of pregnancies had increased age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), fasting plasma glucose (FPG), and fasting insulin, as well as decreased high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR) levels, and proportion of menopause. The prevalence of low-grade albuminuria in parous women gradually increased with parity number. Compared with women with one childbirth, those with more than two childbirths were independently associated with a higher prevalent low-grade albuminuria (odds ratios [ORs] 1.41, 95% confidence interval [CI], 1.09-1.81) after multiple adjustments. In subgroup analysis after multiple adjustments, significant relation between parity number and prevalent low-grade albuminuria was detected in subjects age 55 years or older. CONCLUSION: Number of parity is associated with prevalent low-grade albuminuria in middle-aged and elderly Chinese women without micro- or macro-albuminuria.


Assuntos
Albuminúria/epidemiologia , Paridade , Adulto , Idoso , Albuminúria/etiologia , Pressão Sanguínea , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Prevalência , Circunferência da Cintura
14.
J Dairy Sci ; 102(11): 10030-10038, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521347

RESUMO

Incidences of ketosis, metritis, mastitis, and retained placenta were studied in Israeli Holstein cows calving between 2008 and 2017. These diseases were selected based on their economic impact. Ketosis, metritis, and retained placenta were scored dichotomously. Mastitis was scored as absent, a single occurrence during the lactation, or more than 1 occurrence. Ketosis and metritis were recorded during the first 21 d after calving, retained placenta during the first 5 d after calving, and mastitis up to 305 d in milk. The effects of herd-year-season, calving age, month of calving, gestation length, and occurrence of dystocia were included in the first-parity analysis models. All effects were significant for metritis and retained placenta. For ketosis, all effects were significant, except for gestation length. For mastitis, only the effects of herd-year-season and calving age were significant. Variance components were computed by the multitrait animal model. The 4 diseases were analyzed jointly based on first-parity records, and each disease was analyzed separately for parities 1 to 3 with the different parities considered separate traits. The 4 disease traits in first parity were also analyzed jointly with the 6 major traits included in the Israeli breeding index: milk, fat, and protein production; somatic cell score; female fertility; and longevity. Heritability was highest for metritis and lowest for mastitis, but all heritabilities were <0.07, similar to previous studies. For all 4 diseases, genetic correlations among the first 3 parities were >0.65, and all residual correlations were <0.07. Selection of herd-years assumed to have more accurate recording of mastitis did not result in higher heritability estimates. Genetic correlations between the disease traits and milk, fat, and protein production were economically unfavorable, while correlations between the disease traits and somatic cell score, female fertility, and longevity were economically favorable. Expected genetic changes in the disease traits after 10 yr of selection with the current Israeli breeding index were all <1%, except for ketosis, which was predicted to increase by 1.5%. Inclusion of these traits in a proposed index with the disease traits constituting 7% of the index would result in only marginal improvements for the disease traits and adversely affect genetic gain for fat and protein production. Thus, inclusion of these traits in the breeding index cannot be justified economically.


Assuntos
Doenças dos Bovinos/economia , Indústria de Laticínios/economia , Cetose/veterinária , Mastite Bovina/economia , Placenta Retida/veterinária , Animais , Bovinos , Doenças dos Bovinos/genética , Distocia/genética , Distocia/veterinária , Meio Ambiente , Feminino , Israel , Cetose/economia , Lactação/genética , Longevidade , Leite , Paridade , Fenótipo , Placenta Retida/economia , Gravidez
16.
J Anim Sci ; 97(11): 4635-4646, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31563944

RESUMO

This study tested whether supplemental melatonin given to mimic the extended nighttime melatonin pattern observed in the higher fertility winter season could minimize infertility during summer and fall in swine. Exogenous melatonin was fed during periods coinciding with follicle selection, corpus luteum formation, pregnancy recognition, and early embryo survival. Experiments were conducted at a commercial farm in 12 sequential replicates. In Exp. 1a, mature gilts (n = 420) that had expressed a second estrus were assigned by weight to receive once daily oral Melatonin (MEL, 3 mg) or Control (CON, placebo) at 1400 h for 3 wk starting before insemination at third estrus. In Exp. 1b, parity 1 sows (n = 470) were randomly assigned by lactation length to receive MEL or CON for 3 wk, starting 2 d before weaning. Follicles, estrus, pregnancy, and farrowing data were analyzed for the main effects of treatment, season (4-wk periods), and their interaction. Environmental measures were also analyzed for reproductive responses. In Exp. 1a, there was no effect (P > 0.10) of MEL on age at third estrus (203 d), follicle size after 7 d of treatment (5.0 mm), estrous cycle length (22.6 d), return to service (9.2%), farrowing rate (FR, 80.0%), or total born pigs (TB, 13.6). However, there was an effect of season (P = 0.03) on number of follicles and on gilts expressing estrus within 23 d of the previous estrus (P < 0.005). In Exp. 1b, there was no effect of MEL (P > 0.10) on follicle measures, wean to estrous interval, FR (84.0%), or TB (13.0). But MEL (73.5%) reduced (P = 0.03) estrous expression within 7 d of weaning compared with CON (82.0%) and season (P = 0.001) decreased FR by ~14.0% during mid summer. Also, gilts and parity 1 sows exposed to low light intensity (<45 lx) during breeding had reduced conception (-8%) and farrowing (-15%) rates, compared with higher light intensity. Similarly, high temperatures (>25 °C) during breeding also reduced gilt conception rates by 7%. Although there was clear evidence of seasonal fertility failures in gilts and sows, MEL treatment did not improve fertility in gilts and reduced estrus in parity 1 sows. It is possible that differences in lighting and thermal environments before breeding could explain the differential response to MEL in sows and gilts.


Assuntos
Fertilidade/efeitos dos fármacos , Melatonina/administração & dosagem , Reprodução , Suínos/fisiologia , Animais , Cruzamento , Estro/efeitos dos fármacos , Feminino , Lactação/efeitos dos fármacos , Luz , Tamanho da Ninhada de Vivíparos/efeitos dos fármacos , Paridade/efeitos dos fármacos , Gravidez , Estações do Ano
17.
J Anim Sci ; 97(11): 4608-4618, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31513711

RESUMO

In this study, the effects of maternal energy sources during late gestation and lactation on the performance, glucolipid metabolism, and oxidative status of sows and their offspring were investigated using a total of 75 (2 to 6 of parity) Landrace × Large White sows at day 85 of gestation under 3 different dietary treatments: SO diet (basal diet plus 3.0% and 5.0% soybean oil during late gestation and lactation, respectively), FO diet (basal diet plus 3.0%/5.0% fish oil during late gestation and lactation, respectively), and CS diet (basal diet plus 32%/42% corn starch during late gestation and lactation, respectively). All the 3 groups showed no obvious differences (P > 0.05) in the number of total piglets born, born alive, after cross-fostering, and at weaning, whereas the CS group exhibited a shorter farrowing duration (P < 0.05) and lower stillbirth rate (P < 0.05) when compared with the SO group. In addition, litter weight at birth was significantly higher in the CS group than in the SO or FO group (P < 0.05). Despite no notable differences in the ADG of suckling piglets among dietary treatments (P > 0.05), the CS group had greater feed intake than the SO group during the lactation period (P < 0.05). In neonatal piglets with normal birth weight (NBW, 1.3 to 1.5 kg), the CS group was lower than the SO group in the content of liver glycogen (P < 0.05) and the mRNA abundances of fatty acid synthase, acetyl-CoA carboxylase, fatty acid-binding protein 1, and acyl-CoA oxidase (P < 0.05). Interestingly, compared with the SO group, the FO group had a lower preweaning mortality rate (P < 0.05), but greater liver glycogen pools (P < 0.05) in neonatal piglets with low birth weight (LBW, <1.1 kg). Compared with the CS group, the FO group showed an increase in the plasma malondialdehyde levels (P < 0.05) of sows, as well as an increase of 8-hydroxy-deoxyguanosine (P < 0.05) and a decrease of ferric reducing ability of plasma (P < 0.05) in NBW piglets. Overall, the diet rich in starch decreased the stillbirth rate and increased the litter weight of neonatal piglets, the dietary supplementation with fish oil decreased preweaning mortality rate, and the diet with a low n6:n3 ratio increased the oxidative status of sows and their offspring.


Assuntos
Suplementos Nutricionais/análise , Ingestão de Energia , Óleos de Peixe/administração & dosagem , Óleo de Soja/administração & dosagem , Suínos/fisiologia , Ração Animal/análise , Animais , Animais Lactentes , Dieta/veterinária , Feminino , Lactação , Fenômenos Fisiológicos da Nutrição Materna , Oxirredução , Estresse Oxidativo , Paridade , Gravidez
18.
J Anim Sci ; 97(11): 4557-4566, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31504564

RESUMO

The present study was conducted to evaluate the effects of dietary garcinol supplementation during late gestation (from the 90th day of pregnancy; day 90) and lactation on the acid-base balance of the umbilical cord blood and performance of sows and piglets. Sixty sows (Duroc × Yorkshire × Landrace; second- or third-parity; n = 20) were randomly divided into 3 gestation (day 90 of pregnancy) or lactation treatments, control diet (CON; basal diet), basal diet with 200 mg garcinol, and basal diet with 600 mg garcinol per kg of feed. The body weight (BW); backfat thickness and litter size of the sows; and birth weight, weaning weight, and mortality of piglets were recorded. Sows' blood and piglets' umbilical cord blood were collected for the measurements of hematological parameters and antioxidative and immune indexes, and acid-base balance parameters, respectively. The colostrum and milk and fecal samples of the sows were also collected for analysis of milk composition and apparent total tract nutrient digestibility. Garcinol had no effect on the BW and backfat thickness of the sows but significantly increased the birth weight and weaning weight of piglets (P < 0.05) and decreased the mortality (P < 0.05). Moreover, the white blood cell counts and neutrophil count, mean cell hemoglobin, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activity in the plasma of the sows were increased more significantly (P < 0.05) in the garcinol groups than that in the CON group, whereas the malondialdehyde (MDA) content was decreased (P < 0.05). The garcinol treatment significantly increased the pH, HCO3- and base excess values (P < 0.05), whereas it decreased the pCO2 and lactate content (P < 0.05) in the umbilical blood. Dry matter (DM), ash, and ether extract in the colostrum were similar between groups (P > 0.05), whereas the garcinol significantly increased the crude protein (CP) in the milk. In addition, the content of immunoglobulin A (IgA) and immunoglobulin G (IgG) in the plasma of piglets and in colostrum and milk of sows were increased more significantly (P < 0.05) in the garcinol groups than that in the CON group. The apparent total tract nutrient digestibility was similar between treatments. Collectively, this study indicates that sows fed with garcinol in late gestation and lactation showed improved maternal health and antioxidative status, milk protein content, acid-base balance in the umbilical cord blood, and growth performance in piglets, showing promise in natural plant extract nutrition for sows.


Assuntos
Suplementos Nutricionais/análise , Leite/química , Suínos/fisiologia , Terpenos/administração & dosagem , Equilíbrio Ácido-Base/efeitos dos fármacos , Ração Animal/análise , Animais , Colostro/química , Dieta/veterinária , Feminino , Sangue Fetal/efeitos dos fármacos , Imunoglobulina A/sangue , Lactação/efeitos dos fármacos , Tamanho da Ninhada de Vivíparos/efeitos dos fármacos , Paridade , Gravidez , Distribuição Aleatória , Suínos/sangue , Suínos/imunologia , Desmame
19.
J Anim Sci ; 97(10): 4256-4267, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31504586

RESUMO

This study was conducted to compare the effects of adding sodium butyrate (SB), medium-chain fatty acids (MCFAs), or n-3 polyunsaturated fatty acids (n-3 PUFAs) to the diet of sows during late gestation and lactation on the reproductive performance of sows and the growth performance and intestinal health of suckling piglets. Twenty-four sows (Landrace × Large-White hybrid; third parity; 200 ± 15 kg) were randomly assigned to receive 1 of 4 diets: basal diet (control group), basal diet + 1 g SB/kg (SB group), basal diet + 7.75 g MCFA/kg (MCFA group), or basal diet + 68.2 g n-3 PUFA/kg (n-3 PUFA group). The experiment began on day 85 of gestation and ended day 22 of lactation. Colostrum samples were collected from each sow. After the experiment, blood and tissue samples were collected from 1 randomly selected piglet. The results showed that the weaning-to-estrus interval of sows in the SB, MCFA, and n-3 PUFA groups was shorter than that of sows in the control group (P < 0.05). The incidence of diarrhea in suckling piglets in the SB, MCFA, and n-3 PUFA groups was lower than that of piglets in the control group (P < 0.05). The fat, protein, IgA, IgG, and IgM concentration in colostrum from sows increased following dietary supplementation with SB, MCFA, or n-3 PUFA (P < 0.05). Comparison with the control group, the mRNA expression of claudin-1, zona occludens 1, and interleukin-10 increased in the jejunum mucosa of suckling piglets in the SB, MCFA, and n-3 PUFA groups, while that of TLR4 decreased (P < 0.05). Compared with the control group, the Chao1 and ACE indexes of microbial flora in the colon contents of piglets in the SB, MCFA, and MCFA groups increased (P < 0.05), while the relative abundance of Firmicutes, Actinobacteria, and Synergistetes decreased at the phylum level (P < 0.05). In conclusion, during late pregnancy and lactation, dietary SB supplementation had a greater effect on intestinal health and caused a greater decrease in preweaning mortality of suckling piglets than did dietary MCFA or n-3 PUFA supplementation; dietary MCFA supplementation shortened the weaning-to-estrus interval of sows to a greater extent than did dietary SB or n-3 PUFA supplementation; and dietary n-3 PUFA supplementation increased the fat and protein content in the colostrum to the greatest extent.


Assuntos
Ácido Butírico/farmacologia , Suplementos Nutricionais/análise , Ácidos Graxos Ômega-3/farmacologia , Ácidos Graxos/farmacologia , Reprodução/efeitos dos fármacos , Suínos/fisiologia , Ração Animal/análise , Animais , Animais Lactentes , Colostro/química , Colostro/imunologia , Dieta/veterinária , Feminino , Lactação/efeitos dos fármacos , Paridade , Gravidez , Distribuição Aleatória , Suínos/crescimento & desenvolvimento , Suínos/imunologia , Desmame
20.
J Anim Sci ; 97(10): 4268-4281, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31504612

RESUMO

The objective of the current study was to determine the optimal concentration of dietary standardized ileal digestible (SID) Lys required to maximize litter gain and minimize sow BW loss in modern high-yielding lactating sows when SID CP was kept constant across dietary treatments. A total of 396 parity 1 to 5 sows (L × Y, DanBred, Herlev, Denmark) were included in the study from day 3 after farrowing until weaning at day 26. Sows were allocated to 6 dietary treatments increasing in SID Lys concentration (6.19, 6.90, 7.63, 8.33, 9.04, and 9.76 g/kg). Diets were isoenergetic (14.04 MJ ME/kg as-fed). Litters were standardized to 14 piglets at day 3 ± 2 d postpartum. At day 3 ± 2 d and at day 26 ± 3 d in lactation, litter weight, and sow BW and back fat were registered. On a subsample of 72 parity 2 to 4 sows, litters were additionally weighed at days 10 and 17 ± 3 d, and milk and blood were sampled at day 3 ± 2 d, and 10, 17 and at 24 ± 3 d in lactation. For the 72 sows, body pools of fat and protein were also determined at days 3 ± 2 and 26 ± 3 d using the D2O dilution technique. All data were analyzed as a randomized complete block design using PROC MIXED in SAS. Furthermore, data were subjected to linear and quadratic polynomial contrasts. Variables with quadratic or linear effects or days in milk × treatment interactions were selected for analysis in PROC NLMIXED using linear broken-line models to evaluate optimal SID Lys concentrations. Only models that converged and the best fitting models were included. Average daily litter gain increased until a breakpoint at 8.11 g/kg of SID Lys (as-fed). At and above the breakpoint, multiparous and primiparous sows had litter gains of 3.36 and 2.93 kg/d, respectively. Weaning litter size (13.0 ± 0.1) was similar between the 6 dietary treatments (P = 0.28). Lactation sow BW loss was minimized to 0.17 kg/d at 9.05 g/kg of SID Lys and sow body protein loss was minimized to 0.23 kg at 9.22 g/kg of SID Lys. Linear broken-line analyses showed that for 3, 10, 17, and 24 DIM, plasma urea was minimized at 7.02, 8.10, 8.73, and 8.32 g/kg of SID Lys, respectively, and milk fat was maximized at 7.80 g/kg of SID Lys. In conclusion, in our conditions, high-yielding lactating sows required 8.11 g/kg of SID Lys to maximize litter gain and 9.05 g/kg of SID Lys to minimize sow BW loss. Based on plasma urea, the optimal dietary concentration of SID Lys was lowest in week 1, intermediate in week 2 and 4, and greatest in week 3 of lactation.


Assuntos
Suplementos Nutricionais/análise , Lisina/administração & dosagem , Leite/metabolismo , Suínos/fisiologia , Ração Animal/análise , Animais , Peso Corporal/efeitos dos fármacos , Dinamarca , Dieta/veterinária , Feminino , Íleo/metabolismo , Lactação/efeitos dos fármacos , Tamanho da Ninhada de Vivíparos/efeitos dos fármacos , Masculino , Leite/química , Paridade , Gravidez , Distribuição Aleatória , Suínos/crescimento & desenvolvimento , Desmame
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