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PubMed1992

[The critical period in natural fertility].

In order to learn the natural expectancy period of first pregnancy as well as the influences of some biosocial variables, a clinical-retrospective study was performed within 1120 gravida I women. All of them attended the major institutes of health care in Mexico City (IMSS, ISSSTE, SS and DDF). Data were obtained by means of predetermined questions from subjects after the first postpartum hours. None of them had previously used any contraceptive method. Results showed age at the first pregnancy: 21.6 +/- 3.8 (years); gestational interval 22.1 +/- 19.9 (months) and a 67% achievement rate the following twelve months of sexual activity. Eutocia was seen in 54% of these population and significant linear correlation was attained between age of the patient and the gestational interval. It seems that this is the first information regarding the fertility critical period within our society.

Adolescent↗

PubMed2004

Fat supplementation and reproduction in beef females.

Inadequate dietary energy intake and poor body condition can negatively affect reproductive function. Supplemental lipids have been used to increase energy density of the diet and may also have direct positive effects on reproduction in beef cattle. Several fatty acid sources have been studied as they relate to reproductive function. Common sources include sunflower, safflower, cottonseed, rice bran, soybeans, fishmeal, animal tallow, and calcium salts of fatty acids. Fats have been fed before and after calving, during the breeding season, and during heifer development. Response to fat has been investigated through measuring body weight and body condition score, age at puberty, postpartum interval, first-service conception rates, pregnancy rates, calving interval, calving difficulty, and calf birth and weaning weight. Animal response seems to depend on body condition score, age (parity), nutrients available in the diet, and type of fat supplemented. To elucidate potential mechanisms of action, scientists have investigated changes in follicular and uterine development, hormonal profiles, brain function, and embryonic development. Feeding supplemental fat has resulted in varied and inconsistent effects on reproductive function. Elucidating how supplemental fat can influence reproductive function has been a difficult process. The complexity of the reproductive system and makeup of fat supplements are often confounded by management conditions and forage quality both in research and commercial feeding situations.

Animals↗

PubMed2003

Interrelationships between weight development and weight retention in subsequent pregnancies: the SPAWN study.

BACKGROUND: Pregnancy is frequently associated with post-delivery weight retention in women. Most studies suggest weight retention associated with pregnancy of between 0.5 to 3.8 kg with up to 2.5 years of follow-up. However, 73% of the female patients at our obesity clinic report that their pregnancies have been important trigger factors for marked weight gain and that they had gained more than 10 kg after each pregnancy. The aim of this study was to examine correlations in weight gain and weight retention after pregnancy in the long-term perspective. METHOD AND SUBJECTS: The SPAWN (Stockholm Pregnancy and Women's Nutrition) study is a long-term follow-up study of women who delivered children in 1984-85 in Stockholm (n = 2342). The participants filled out questionnaires about their eating and exercise habits, social condition, etc. before, during and up to 1 year after pregnancy. Antropometric data were also sampled. One thousand four hundred and twenty-three women completed the study and filled out all questionnaires up to 1 year after pregnancy. Fifteen years later, these 1423 women were invited to the follow-up study. Five hundred and sixty-three women participated and filled out extended questionnaires, and antropometric data were also sampled. Data from the Swedish Medical Birth Register (MBR) about weight before and weight gain during pregnancy were collected. The sample was divided into groups regarding four critical time periods: (1) Time interval between first and second pregnancy, less and more than 2 years. (2) Overweight and normal weights before first pregnancy based on initial body mass index (BMI). (3) Low and high weight gainers during pregnancy by mean split. (4) Low and high weight retainers at 1 year after first pregnancy by mean split. RESULTS: 1) There were no differences between those women who have more than 2 years between their pregnancies regarding weight gain during and weight retention after the first and second pregnancy. (2) Overweight women did not gain more weight during pregnancy or retain more weight at 1 year of follow-up after the first and second pregnancy. (3) High weight gainers retained more weight at 1 year after both the first and second pregnancy. (4) High weight retainers had gained more during pregnancy and retained it into the second pregnancy, and also gained more during and retained more after the second pregnancy. DISCUSSION: To our knowledge, the SPAWN study is the longest follow-up study of factors affecting weight development after pregnancy. Women overweight before pregnancy did not have any higher risks of postpartum weight retention than normal weight women. Weight gain during pregnancy and weight retention up to 1 year after delivery is of predictive value for the weight development in the second pregnancy. Obviously the environmental variation is an important determinant of the differences in weight increase, which follow a pregnancy. Pregnancies time interval does not seem to be of any importance. There are practical implications of these findings: Women who plan their later pregnancy several years after the first pregnancy have no reason to assume that the weight development during subsequent pregnancies will be worse than before. On the other hand, women who have increased considerably in weight during the first pregnancy or retained weight after delivery have a higher risk of doing so in the subsequent pregnancies and should receive appropriate advise and support.

Adult↗

PubMed1991

Risk of IDDM in children of diabetic mothers decreases with increasing maternal age at pregnancy.

Offspring of women with insulin-dependent diabetes mellitus (IDDM) have a significantly lower risk of IDDM than the offspring of men with IDDM. Furthermore, a negative association of the risk of IDDM in the offspring with maternal age at delivery has been reported. This study tested the association with maternal age in an independent set of families (n = 103) in which the mother had at least one pregnancy before and after the onset of IDDM. In the 304 offspring, the mean +/- SE risk of IDDM by age 20 was 6.0 +/- 2.4% for those born at maternal ages less than 25 yr, whereas, the risk was significantly lower (0.7 +/- 0.7%) for those born at older maternal ages (P = 0.03). These 304 offspring were combined with a sample of 1391 offspring previously reported for a multivariate analysis of other factors related to pregnancy. In the combined analysis, the risk of IDDM in offspring born at maternal ages greater than 25 yr was one-fifth that for offspring born to younger mothers. The risk of IDDM in the offspring was not significantly related to birth order, mother's age at first pregnancy, or the interval between pregnancies for subsequent ones. The risk for the children born before the mother's onset of diabetes was higher than that for those exposed in utero to her diabetes, but the difference did not reach statistical significance. In conclusion, although genetic factors are important determinants of susceptibility to IDDM, exposure to maternal diabetes protects offspring from IDDM during the first 2 decades of life.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1982

Secular change in birthweight of Asian babies born in Birmingham.

We have studied changes in the birthweight of Asian babies born alive at this hospital between 1968 and 1978. In 1978 Pakistani babies were 139 g heavier but Indian babies only 25 g heavier than 10 years earlier. Contributing to these changes were significantly fewer short mothers and primiparae among Pakistanis, and non-significant increases in gestational age and intrauterine growth (that is, weight centile after allowing for gestational age, parity, and maternal height). Among Indians there were significant increases in maternal height and gestational age, but parity was reduced and intrauterine growth did not increase. In both groups there were fewer teenage mothers, but whereas among Pakinstanis birth intervals of less than one year were less common, there was no such reduction among Indian mothers. The secular change suggests that genetic factors are unlikely to be the major reason why Pakistani babies born in Birmingham are lighter than European babies, and that environmental factors play an important role. Efforts to increase birthweight need to consider both the mothers' physical environment during pregnancy and prepregnancy factors influencing growth in childhood, age at first pregnancy, and birth interval. The study shows a need to describe an 'Asian' population with details of their sub-ethnic structure. The sub-ethnic and secular differences further suggest that a single 'Asian' standard for birthweight and intrauterine growth may be inappropriate; the use of international reference data with which all infants may be compared is preferable.

Adolescent↗

PubMed1991

Multivariate analysis of factors associated with calving interval and calving rate in dairy cows.

We collected data on reproductive events of cows (n = 2116) that included dates of calving, first service, last artificial insemination before pregnancy examination, pregnancy examination, abortion, diagnosis of cystic ovary, and treatment with prostaglandin. We used multivariate analysis to evaluate the relationship between the interval from insemination to pregnancy examination and the length of calving interval, adjusting for other factors affecting the calving interval. The effect of the interval from insemination to pregnancy examination on calving rate was estimated using logistic regression analysis. The calving interval was long for cows with a short interval from artificial insemination to first pregnancy examination, it was at a minimum at 55 d and increased thereafter. Other factors affecting the calving interval were cystic ovaries, prostaglandin treatment, abortion, number of artificial inseminations, and days to first service. The calving rate was low among cows with a short interval to pregnancy examination, reached a maximum at 48 d, and then declined. Other factors affecting the calving rate were abortion, number of artificial inseminations and whether the cow was bred by a clean-up bull.

Journal Article↗

PubMed2004

Stress urinary incontinence 4 years after the first delivery: a retrospective cohort survey.

BACKGROUND: Our aim was to estimate the prevalence of stress urinary incontinence 4 years after the first delivery and analyze its risk factors. METHODS: A retrospective cohort survey was conducted in a French university hospital. The 669 primiparous women who delivered in our department in 1996 a singleton in a vertex position between 37 and 41 weeks of amenorrhea were included. A mailed questionnaire was sent 4 years after the indexed delivery. The main outcome measure was stress urinary incontinence 4 years after the first delivery. RESULTS: Three hundred and seven women replied, 274 had moved and 88 did not respond. Four years after the first delivery, prevalence of stress urinary incontinence was 29% (89/307). According to multiple logistic regression analysis, the independent risk factors were urine leakage before the first pregnancy [odds ratio (OR) 18.7; 95% confidence interval (CI) 3.6-96.4], urine leakage during the first pregnancy (OR 2.5; 95% CI 1.3-4.8), duration of first labor > or = 8 h (OR 3.1; 95% CI 1.7-5.7), mother's age > 30 years at the first delivery (OR 2.4; 95% CI 1.4-4.2) and cesarean section at the first delivery (OR 0.3; 95% CI 0.1-0.9). CONCLUSION: Our results suggest that stress urinary incontinence after pregnancy arises from a multifactorial condition. The main risk factors are: age, previous incontinence (before or during the first pregnancy), prolonged labor and vaginal delivery.

Adult↗

PubMed1978

The interactive effects of induced abortion, inter-pregnancy interval and contraceptive use on subsequent pregnancy outcome.

Prior induced abortion and outcome of the next pregnancy are investigated, allowing for two intervening and potentially confounding variables: 1) length of interval between the termination of the first pregnancy and the conception of the next (inter-pregnancy interval) and 2) the utilization of contraception during this interval. Results show that non-contracepting (susceptibility) intervals which immediately precede a subsequent pregnancy are significantly shorter following an induced abortion than those following a spontaneous abortion or delivery. A life table analysis of all susceptibility intervals confirmed this finding. To investigate outcome of subsequent pregnancy as influenced by preceding pregnancy outcome, inter-pregnancy interval and contraceptive use in the interval, a categorical linear model has been developed. Among non-contraceptors, the model indicates no differences in proportions of succeeding adverse outcomes (spontaneous abortion or low birth weight) regardless of inter-pregnancy interval and whether or not the preceding pregnancy had been terminated by an induced abortion. For the contraceptive users, however, proportions of adverse outcomes increased with length of inter-pregnancy interval, and, within each interval category, proportion of adverse outcomes was higher when the preceding pregnancy had terminated in an induced abortion.

Abortion, Induced↗

PubMed1995

Reproductive factors and breast cancer risk. Effect of age at diagnosis.

The data from a French case-control study of 495 patients with breast cancer and 542 control subjects interviewed in five French public hospitals, were analyzed to assess the effect of reproductive factors (age at menarche, age at first full-term pregnancy, the time interval between these two ages, and parity) on the risk of breast cancer. Age at menarche, age at first full-term pregnancy, the time interval between these two ages, and parity appeared to have a limited influence on breast cancer risk. However, the relationship between these factors and the risk of breast cancer varied according to the age at breast cancer diagnosis. In the youngest group of women, the most consistent effects came from factors occurring early in life (menarche, first full-term pregnancy, and consequently the time interval between these two events). These factors had a null or weak effect on the oldest group of women. The protective effect of high parity was confined to the oldest group of women.

Adult↗

PubMed2001

Pregnancy outcome and birth spacing among Palestinian women between 1940 and 1989.

In a sample of 1,250 Palestinian women living in cities, villages and refugee camps of the West Bank over a period of 50 years, we studied the number of pregnancies, children and miscarriages per woman, the waiting time to the first pregnancy, birth spacing between children, and the average age of women at first live birth. The average number of pregnancies, the percentage of miscarriages, the waiting time to the first pregnancy and the birth interval between children decreased with time in all locations. The average age of women at first live birth in cities and villages showed very little difference, but slightly lower in refugee camps.

Abortion, Spontaneous↗

PubMed1983

Clitoral stimulation and the effect of age, breed, technician, and postpartum interval on pregnancy rate to artificial insemination in beef cattle.

An experiment was conducted to assess the effect of clitoral stimulation on pregnancy rate to artificial insemination in 1,856 beef females. For unadjusted data, pregnancy rate to first service in nonstimulated females was 61% for cows and 59% for heifers, and that of females receiving clitoral stimulation was 69% for cows and 58% for heifers. After adjusting the data for the influences of age, breed, technician, and postpartum interval, clitoral stimulation increased first service pregnancy rate in cows (74+/-3% vs 59+/-3%, P<0.05), but not in heifers (53+/-5% vs 57+/-5%, P>0.10). Postpartum interval significantly influenced pregnancy rate, regardless of treatment, and clitoral stimulation was beneficial when applied to cows with relatively short postpartum intervals. Variation in the effect of clitoral stimulation on pregnancy rate was observed among technicians. Clitoral stimulation improved pregnancy rate more effectively in 3 to 4 year old cows than in cows 2 years old and cows 5 years of age or older. We concluded that clitoral stimulation at the time of artificial insemination was an effective means of increasing pregnancy rate in cows, but not in heifers.

Journal Article↗

PubMed1991

Embryotoxicity and teratogenicity of DL111-IT, an early pregnancy-terminating agent, in the subsequent gestation following administration in rats.

DL 111-IT is a new non-hormonal early pregnancy-terminating agent. The subsequent embryotoxic and teratogenic effects of DL111-IT were studied in the rats whose first pregnancy had been terminated by the agent. The secondary pregnancy of the treated rats were allowed to initiate at 30-, 45-, and 90-day intervals, respectively, after the termination of the first pregnancy. The toxicities primed with DL111-IT, such as resorbed embryos and nephrohydrosis fetuses, were found to be 8.0% and 8.5%, respectively, in the rats with pregnancy at 30-day interval. This is significantly different from 4.0% resorbed embryos and 2.4% nephrohydrosis fetuses in vehicle control (P less than 0.05). However, the rate of resorbed embryos decreased to 7.0% or 6.0% in the rats with pregnancy at 45- or 90-day intervals, respectively. No other significant embryotoxicity and teratogenicity were observed in those rats initiating their pregnancy 45 days later after first-pregnancy termination by DL111-IT. Thus, DL111-IT appears to have very low subsequent toxicity in the course of rat pregnancy cycles.

Abnormalities, Drug-Induced↗

PubMed1982

Epidemiology of breast carcinoma IV: age and histologic tumor type.

The purpose of this study was to correlate major chronologic events known to have a bearing on the risk for developing breast carcinoma with histologic tumor type. Data were obtained for 1024 consecutively treated patients with the seven most common forms of mammary carcinoma. The age of occurrence of the following events was determined: menarche; first marriage; first pregnancy and first childbirth; last pregnancy and last childhood; diagnosis. The interval between each of these events and diagnosis of breast cancer was also calculated. Patients with medullary carcinoma had a significantly lower mean age at diagnosis than those with any of the other tumor types. Because of the lower mean age at diagnosis, medullary carcinoma patients were found to have significantly shorter intervals between age at diagnosis and the following: menarche, first pregnancy or first childbirth, and last pregnancy or last childbirth. Intervals between age at diagnosis and these other events were not significantly different among patients with other types of carcinoma. The ages of menarche, marriage, or pregnancy were not related independently to any tumor type. These data indicate that except for current age, the age of occurrence of major risk factors for developing breast cancer is unrelated to the histological type of tumor a patient develops.

Adult↗

PubMed2002

Genetic and phenotypic relationships among endocrine and traditional fertility traits and production traits in Holstein-Friesian dairy cows.

The objective of this study was to estimate the heritability of a number of traditional and endocrine fertility traits in addition to d-56 predicted milk yield (MY56), and the genetic and phenotypic correlations between these traits. Various fixed effects such as season, year, herd, lactation number, diet, percentage Holstein (PCH) of the cow, and occurrence of uterine infection (UI), dystocia (DYS), and retained placenta (RP) were also investigated. Data collected for 1212 lactations of 1080 postpartum (PP) Holstein-Friesian dairy cows in eight commercial farms between 1996 and 1999 included thrice weekly milk progesterone samples, calving and insemination dates, various reproductive health records, monthly/bimonthly production records, three-generation pedigrees, and PCH information. Genetic models were fitted to the data to obtain heritabilitites and correlations using ASREML. Estimates of heritability for interval to commencement of luteal activity PP (lnCLA), length of the first luteal phase PP (lnLutI) and occurrence of persistent CL type I (PCLI) were 0.16, 0.17, and 0.13, respectively. Heritabilities for pregnancy to first service (PFS), interval to first service (IFS), and MY56 were 0.14, 0.13, and 0.50, respectively. Genetic regressions of lnCLA and lnLutI on PTA of the sire for milk, fat, and protein yields, and PIN95 were investigated. Regressions of lnCLA were positive and significant on fat yield, while regressions of lnLutI on both protein yield and PIN95 were negative and significant. Genetic correlations of endocrine fertility traits (lnCLA, lnLutI, and PCLI) with MY56 were high (0.36, P < 0.05; -0.51, P < 0.05; and -0.31, P < 0.1, respectively). Percentage Holstein of the cows had no significant effect on any of the fertility parameters monitored. This work emphasizes the strong genetic correlation of fertility with production traits and, therefore, highlights the urgent requirement for selective breeding for fertility in the United Kingdom. The high heritability of endocrine fertility traits stress their potential value for inclusion in a selection index to improve fertility.

Animals↗

PubMed2004

Use of hormonal contraceptives and occurrence of pregnancy-related pelvic pain: a prospective cohort study in Norway.

BACKGROUND: Pregnancy-related pelvic pain is a common condition, and use of hormonal contraceptives before pregnancy has been proposed as a risk factor. We used data from a sub-sample of women participating in the "Norwegian Women and Cancer study" (NOWAC) to assess the association between hormonal contraceptive use and pelvic pain in pregnancy. METHODS: From a sub-group of 2078 parous women participating in the NOWAC study, information was collected from a self-instructive four-page questionnaire containing questions about lifestyle and medical conditions. We calculated odds ratios (OR) and 95% confidence intervals (CI), using unconditional logistic regression. RESULTS: In this study, the prevalence of pelvic pain in women was 26.5% during the first pregnancy and increased with parity. Use of hormonal contraceptives before a woman's first pregnancy was associated with an increased risk of pelvic pain in her first pregnancy (OR = 1.6; 95% confidence interval 1.2-2.2). There was no association between use of hormonal contraceptives and pelvic pain in the second or third pregnancy. Occurrence of pelvic pain in a previous pregnancy was the only factor associated with pelvic pain in subsequent pregnancies (OR = 51.1; 95% CI 32.9-79.5 in the second pregnancy and OR = 28.3; 95% CI 15.4-53.1 in the third pregnancy). CONCLUSION: Use of hormonal contraceptives was associated with an increased risk of pelvic pain in a woman's first pregnancy. The most important determinant of pelvic pain in the second or third pregnancy was the history of pelvic pain in the preceding pregnancy.

Journal Article↗

PubMed1994

A population-based study of gastroschisis: demographic, pregnancy, and lifestyle risk factors.

Gastroschisis, an abdominal wall defect, most often occurs in infants of young mothers. To identify risk factors for gastroschisis, we conducted a case-control study in the population surveyed by the California Birth Defects Monitoring Program (CBDMP). From structured questionnaire data, we compared sociodemographic, reproductive, and lifestyle factors for 110 mothers of infants with gastroschisis with those for 220 age-matched mothers of normal infants. Univariate matched-pair analysis showed significant associations of gastroschisis with mother's education, yearly family income, marital status, a history of mother's mother smoking, mother's father's absence from home during the mother's youth, more than one elective abortion, a short interval between menarche and first pregnancy, siblings from different fathers, and use of either a recreational drug (either cocaine, amphetamine, marijuana, or LSD), alcohol, or tobacco during the trimester preceding pregnancy. For cocaine, amphetamine, and marijuana, use of more than one drug showed a stronger association than single drug use. The association was stronger if both parents used drugs. Although many variables were correlated, odds ratios (OR) were significant (95% confidence intervals) in multivariate conditional logistic analysis for: yearly family income < $10,000 [OR = 4.34 (1.54, 12.22)] or $10,000-$49,999 [OR = 3.93 (1.43, 10.80)]; mother's mother's smoking status not known [OR = 3.99 (1.66, 9.56)]; mother's father's absence from home during her youth [OR = 3.11 (1.14, 8.46)]; and drug use by mother [OR = 2.21 (1.21, 4.03)], father [OR = 1.66 (1.02, 2.69)], or both [OR = 3.05 (1.48, 6.28)]. The best predictive model explained 32% of the deviance. Young, socially disadvantaged women with a history of substance use were at highest risk for a child with a gastroschisis.

Abdominal Muscles↗

PubMed1993

Fertility after ectopic pregnancy.

OBJECTIVES: To compare pregnancy rates (PRs) after radical or conservative surgical treatment for tubal pregnancy over a 12.5-year interval (minimum of 3 years) and to assess the relative contribution of various risk factors to future fertility performance. DESIGN: A retrospective cohort study examining the influence of various risk factors on PRs with stepwise discriminant analysis using a jackknife-type validation program. PATIENTS: Eighty-eight Olmsted County, Minnesota, women who presented over a 10-year interval with their first ectopic pregnancy (EP), undergoing either radical or conservative surgery at laparotomy, who actively attempted conception after surgery and who were available for follow-up at Mayo Clinic. MAIN OUTCOME MEASURES: The primary end point for analysis was the occurrence of a livebirth or EP at 3 years of follow-up after the index EP. RESULTS: No difference in PR was identified in patients treated with radical or conservative surgery. Patients who underwent conservative surgery had a higher risk of subsequent EP. Patients with a prior history of infertility had significantly reduced fertility potential. CONCLUSIONS: Prior history of infertility was the most significant determinant for fertility potential after surgical treatment for EP. Patients with prior infertility had markedly impaired fertility after surgical treatment of EP, and outcome was not influenced by choice of surgical procedures. Patients without prior infertility had comparable encouraging fertility potential with both conservative and radical therapy. These findings have relevance for future management of infertility in affected patients.

Discriminant Analysis↗

PubMed2006

Recurrence of clinical chorioamnionitis in subsequent pregnancies.

OBJECTIVE: To establish the role of clinical chorioamnionitis as an independent risk factor for recurrence in a subsequent pregnancy. METHOD: This was a historical cohort study of pregnant women who had their first and second deliveries at our institution between January 1988 and May 2005. The index pregnancy was restricted to those who delivered vaginally. Data were collected from a continuously updated obstetric database and included demographic and labor characteristics and neonatal outcomes. Chorioamnionitis was diagnosed clinically. RESULTS: The study population consisted of 23,397 women. During the index pregnancy, 10% of women developed chorioamnionitis. This group was significantly different from the rest of the cohort in terms of age, ethnicity, length of labor, epidural analgesia, use of internal monitors, and incidence of prolonged rupture of membranes. In the second pregnancy, 6% of those women again developed chorioamnionitis compared with 2% of women who did not have chorioamnionitis in the first pregnancy (odds ratio 2.93, 95% confidence interval 2.40-3.57). After adjusting for the above confounders, the increased risk of recurrence persisted (odds ratio 1.85, 95% confidence interval 1.49-2.30). CONCLUSION: Women delivering vaginally who were diagnosed with chorioamnionitis during their first pregnancy are at increased risk for chorioamnionitis in a subsequent pregnancy. This supports the concept that there may be a predisposition to chorioamnionitis that should be further investigated. LEVEL OF EVIDENCE: II-2.

Adult↗