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PubMed1988

Short interpregnancy interval and the risk of low birthweight.

The effect of interpregnancy interval on the birthweight of the subsequent child was investigated in a cohort of 5,938 women who registered for two consecutive pregnancies in the Collaborative Perinatal Project. Mean birthweight increased from 3,101 grams for intervals of less than 3 months to 3,193 grams for intervals of 15-17.9 months and remained stable thereafter (p for trend = 0.006). However, women with shorter intervals were younger, lighter weight, and less educated at the beginning of the first pregnancy than were women with longer intervals; the birthweight of their previous child was lower, and they were of marginally lower socioeconomic status. Adjustment for confounders reduced the maximum difference in mean birthweight by interval length from 92 to 39 grams, and blunted the trend for lower birthweights with shorter intervals (p = 0.45). Similarly, adjustment reduced the increased risk of low birthweight among women with the shortest intervals from 52 per cent to 12 per cent. We conclude that a short interpregnancy interval is primarily a marker for a woman who is otherwise at high risk, and that modification of this interval alone may be unlikely to have a major impact on low birthweight.

Birth Intervals↗

PubMed1990

Recall of alcohol consumption during pregnancy.

This is a test-retest reliability study of self-reported alcohol use during pregnancy, in which two groups of women provided two reports about their first trimester drinking over a 3-month interval (Group 1) and over a 5-month interval (Group 2). Women in Group 1 (n = 91) were queried about first trimester alcohol consumption during their fourth month of pregnancy and again during their seventh month, a 3-month recall interval. Group 2 women (n = 88) provided first trimester drinking reports during their fourth month of pregnancy and again at delivery, a 5-month recall interval. The test-retest Pearson correlation coefficient for recall of first trimester average daily volume (ADV) was .61 (p = .000) for Group 1 and .53 (p = .000) for Group 2. When the ADV scores were grouped into five ordinal categories, 51.6% of Group 1 and 56.8% of Group 2 remained in the same category at test and retest. This leads to the conclusion that self-reported alcohol consumption is moderately reliable over a 3-month and a 5-month time period.

Adolescent↗

PubMed1999

Reproductive biology of female titi monkeys (Callicebus moloch) in captivity.

Titi monkeys (Callicebus spp., Cebidae) are monogamous neotropical primates that live in family-like groups typically consisting of an adult monogamous pair and one or two young. Knowledge about the reproductive biology of this genus is scanty. This study investigated the reproductive biology of female dusky titi monkeys (Callicebus moloch). An initial analysis characterized reproductive parameters of 32 females from a captive colony maintained for 23 years at the California Regional Primate Research Center (CRPRC). The colony records provided data on reproductive parameters such as interbirth intervals, seasonality, age at first pregnancy, and reproductive rate in captivity. Changes in urinary levels of estrone conjugates (E1C) and pregnanediol-3alpha-glucuronide (PdG) were used to characterize major reproductive events. Urine samples from eleven females were collected during 17 months. The endocrine data were used to examine changes associated with cycling, conception, and the post-partum period as well as to determine the duration of the ovarian cycle and gestation length. The analysis of colony records indicated that females whose infant survived through weaning gave birth at intervals remarkably close to one year, while those who lost their offspring showed a significantly shorter interval. As long as they lived within the family group, mature female offspring did not breed. The analysis of the endocrine profiles indicated that after giving birth to a viable offspring, females undergo a relatively prolonged period of anovulation (approx. 6.5 months), followed by 1-3 non-conceptive cycles (approx. 1 month), after which they conceive and gestate (4.3 months).

Animals↗

PubMed1994

Determinants of low birth weight: a community based prospective cohort study.

The study aimed at identifying and quantifying determinants of low birth weight (LBW) by following a community based prospective cohort of pregnant women in 45 villages in Pune district. In the 1922 live births born to mothers without a chronic illness, in whom birth weight was available within 24 hours, the cumulative incidence of LBW (< 2500 g) was 29%. The unadjusted relative risks for LBW were significantly higher for lower socio-economic status (RR = 1.71), maternal age less than 20 years (RR = 1.27), primiparity (RR = 1.32), last pregnancy interval less than 6 months (RR = 1.48), non-pregnant weight less than 40 kg (RR = 1.3), height below 145 cm (RR = 1.51), hemoglobin less than 9 g/dl (RR = 1.53) and third trimester bleeding (RR = 1.87). Multivariate logistic regression analysis showed that the adjusted odds ratio for LBW decreased with increasing gestational duration, non-pregnant weight, parity and rising education level of the mother. Socio-economic status, non-pregnant weight, maternal height, and severe anemia in pregnancy had substantial attributable risk per cent for LBW (41.4%, 22.9%, 29.5% and 34.5%, respectively). The findings suggest that selectively targetted interventions such as improving maternal education and nutrition, specifically anemia, wider availability of contraception to delay the first pregnancy and to increase pregnancy intervals may help in identifying and ensuring adequate care for those women at greatest risk of LBW.

Adult↗

PubMed1981

Effects of the timing of marriage and first birth of the spacing of subsequent births.

Analyzing data from a fifteen-year follow-up survey of high school students originally surveyed in 1957-58 and resurveyed in 1973-74, this paper examines the effects of the timing of marriage and first birth on subsequent childspacing, holding constant the effects of other variables that may be sources of spuriousness. The results suggest that age at first marriage has a causal effect on the occurrence of a short first birth interval and that age at first marriage and premarital pregnancy interact in their effect on the occurrence of a short second birth interval. Age at first marriage has no causal effect on the spacing of the second birth for those whose first child was maritally conceived. The spacing of the first birth, however, appears to have a causal effect on the spacing of the second.

Adult↗

PubMed2001

Higher risk of pre-eclampsia after change of partner. An effect of longer interpregnancy intervals?

Epidemiologic studies have shown that pre-eclampsia is mainly a disease of first pregnancy, possibly associated with primipaternity. The interpregnancy interval, which is strongly associated with change of partner, has received little attention. In this study, based on Danish hospital records, we evaluated whether the interpregnancy interval may confound or modify the paternal effect on pre-eclampsia. We studied the outcome of the second birth in a cohort of Danish women with pre-eclampsia in the previous birth (8,401 women) and in all women with pre-eclampsia in second (but not first) birth together with a sample of women with two births (26,596 women). A long interpregnancy interval was associated with a higher risk of pre-eclampsia in women with no previous pre-eclampsia when the father was the same. We estimated the risk of pre-eclampsia in second birth according to paternal change in different models. Although partner change was associated with an increased risk of pre-eclampsia in women with no history of pre-eclampsia, this effect disappeared after adjustment for the interpregnancy interval. We saw, however, different results when we stratified on the length of the interval. Our results indicate that the interval between births should be taken into consideration when studying the effect of changing partner on pre-eclampsia.

Adult↗

PubMed1989

Ultrasonographically determined thyroid size in pregnancy and post partum: the goitrogenic effect of pregnancy.

Thyroid function and ultrasonographically determined thyroid volume were investigated at regular intervals during pregnancy and the first postpartum year in 20 women without thyroid autoantibodies. Serum total thyroxine and total triiodothyronine levels were increased and free thyroxine index and free triiodothyronine index levels were decreased, whereas serum thyrotropin level was unaltered during pregnancy when compared with postpartum levels. Thyroid volume was increased during pregnancy with a mean variation of 30% between maximum values (24.1 +/- 2.2 ml, mean +/- SEM, thirty-sixth week of pregnancy) and minimum values (18.4 +/- 2.0 ml, 12 months post partum) (p less than 0.01). In conclusion, our study demonstrates a goitrogenic effect of pregnancy unexplained by alterations in thyroid function variables.

Adult↗

PubMed1989

Fertility, menstrual characteristics, and contraceptive practices among white, black, and Southeast Asian refugee adolescents.

This study compares fertility and menstrual characteristics and contraceptive practices of white, black, and Southeast Asian refugee adolescents participating in the Minneapolis Health Department's Maternal and Infant Care Program between 1980 and 1982. Mean ages were similar among all racial groups; however, half the Hmong adolescents had a live birth as compared to less than 25% of the other racial groups. More than 75% of the Hmong and other Southeast Asian adolescents were married as compared to 11% of the whites and 8% of the blacks. Menarche was significantly later (2 years) for Hmong and other Southeast Asians, and the interval between menarche and first pregnancy was significantly shorter for the Hmong. While more than half of the whites and blacks previously used contraception, 14% of the Hmong and 29% of the other Southeast Asians had used contraception. Oral contraceptives were the most frequently used method for whites, blacks, and Southeast Asians; the Hmong were equally likely to choose oral contraceptives or barrier methods. The Hmong were less likely to choose contraception postpartum than were the other groups.

Adolescent↗

PubMed1988

Breast cancer in relation to early use of oral contraceptives. No evidence of a latent effect.

A long-term effect of oral contraceptives (OCs) on breast cancer risk has been suggested as an explanation for some studies' failure to detect an association between OCs and breast cancer. To address this latency hypothesis, we analyzed data on 4714 case subjects and 4540 control subjects from the population-based Cancer and Steroid Hormone Study. No support was evident for a latent effect of OCs on breast cancer risk through age 54 years: among parous women who had cumulated more than six years of OC use before their first term pregnancy, the risk of breast cancer, relative to nonusers before first term pregnancy, was 0.6 at zero to four years after first term pregnancy (95% confidence interval [Cl], 0.2 to 1.8), 0.7 at five to nine years (95% Cl, 0.3 to 1.7), and 1.1 at ten to 14 years (95% Cl, 0.3 to 3.9). Among nulliparous women with more than six years of OC use in total, the relative risk of breast cancer, by interval from last use of OCs, was 1.3 at zero to four years (95% Cl, 0.8 to 2.0), 1.1 at five to nine years (95% Cl, 0.5 to 2.0), and 0.6 at ten to 14 years (95% Cl, 0.1 to 3.7).

Adult↗

PubMed1995

An initial assessment of the risk approach to antenatal management in Malaysia.

This study was the first assessment of a nationwide risk approach system to antenatal management introduced to Malaysia in 1989. Three rapid, record-based surveys on three different study groups were conducted to determine risk factor prevalence, accuracy of risk assignment, action after risk assignment and the relationship of risk level and place of delivery. The most frequent risk factors were short birth interval, high parity and first pregnancy. Accuracy of risk assignment was highest at the lowest levels of risk and poorest at the highest levels. Women at the lowest levels of risk were more likely to be seen by a doctor than women at highest risk. These was a trend to deliver in hospital, rather than at home, as level of risk increased; but many women at high risk still delivered at home. Recommendations are made on modifications to the system prior to future evaluation.

Adult↗

PubMedDate not supplied

[The importance of time intervals between childbirth and anemia in pregnancy].

UNLABELLED: During pregnancy some parameters have been studied in order to detect anaemia: amount of erythrocytes, haematocrits, haemoglobin and iron in the serum of 100 women-secundiparae. The greater group of pregnant women (68%) decided for the second pregnancy after two years, while the smaller group (32%) after four years at least. All parameters related to anaemia were present in the groups of shorter time intervals between births. Thus, in the first trimester anaemia was detected in 13.3% of pregnant patients, while only 7.1% in those with a longer interval between deliveries. In the second trimester 33.3% of pregnant women with shorter time intervals suffered from anaemia, and 14.3% of those with a longer interval. The difference is also significant in the third trimester. Namely, 50% of pregnant patients with a shorter interval were anaemic, in comparison to 21.4% of women with a longer interval between deliveries. INTRODUCTION: Anaemia is one of the most frequent illnesses in pregnant patients. The authors found different percentages of its presence in the range from 21 to 80 percent. Sideropenic anaemia is the most common in pregnancy. As Iron is being consumed and lost during delivery, it takes time for its restitution. Therefore Dazabarova advises another childbirth after three years. PURPOSE: Pregnancy and delivery exhaust the organism. It takes time for the recovery and a new pregnancy. Therefore, the purpose of this paper was to examine in what way the time-interval may affect anaemia. METHOD: This paper covers 100 randomized secondiparae. Laboratory examinations were carried out three times during pregnancy, in each trimester separately. The results are shown on the graph so that the difference and importance of the time-interval between deliveries regarding anaemia in pregnant patients, can be noticed. RESULTS: Pregnant women with a two-year interval between deliveries showed anaemia to a greater extent during pregnancy (Graph 1). This was confirmed by tests and was statistically significant (chi 2 = 14.275 and p < 0.001). In women with an interval of four years between deliveries, changes in number of erythrocytes were not statistically significant (chi 2 = 1.167 and p > 0.05). Thus, the difference among the analyzed groups was significant in all trimesters of pregnancy. The results of haematocrits are presented in Graph 2. The difference between the results of greater presence of anaemia in women with shorter time-interval between pregnancies may be statistically significant in the first and second trimesters. In the third trimester, however, the difference still existed, although it was not statistically significant. The results of haemoglobin indicating anaemia (Graph 3) were found in a greater number as pregnancy progressed in women with shorter time-interval between deliveries. This was statistically significant (chi 2 = 15.600 and p < 0.001). In women with greater time-interval between deliveries, a slight increase in haemoglobin was detected, indicating anaemia (chi 2 = 5.918 and p < 0.05). Iron concentrations in the serum indicating anaemia (Graph 4) were constantly decreasing during pregnancy (chi 2 = 7.251 and p < 0.01) in patients with shorter intervals between deliveries, whereas in women with greater time-intervals no significant changes were found (chi 2 = 1.838 and p > 0.05). In Graph 5 the prevalence of anaemia is presented according to the examined parameters. Anaemia was greater in a far larger number of women with shorter intervals between deliveries. This difference is at the limit of statistical significance in the first trimester, tending to become statistically highly significant in the second and third trimesters. DISCUSSION: Frequent pregnancies are one of the causes of anaemia. Namely, they are more often detected in multiparae with shorter time-intervals between deliveries. Our study has confirmed that pregnancy causes haemotopoietic changes (ABSTRACT TRUNCATED).

Anemia↗

PubMed1995

Effects of pregnancy on first onset and symptoms of paroxysmal supraventricular tachycardia.

It is important for women to understand the risk of first onset and symptomatic exacerbation of paroxysmal supraventricular tachycardia (SVT) during pregnancy. Reports regarding the effects of pregnancy on first onset and symptomatic exacerbation of paroxysmal SVT have been controversial, and have not been conducted in a systematic fashion. Two hundred seven consecutive female patients diagnosed with symptomatic paroxysmal SVT were requested to respond to multiple questionnaires before electrophysiologic study and catheter ablation. A person-years data method was used to estimate risk of first onset of paroxysmal SVT during pregnancy. Exacerbation of paroxysmal SVT was assessed by a score scale including each of the following symptoms: palpitation, fatigue, rest dyspnea, effort dyspnea, dizziness, chest oppression, blurred vision, and syncope (total score change > 2 points). In the 107 patients with accessory pathway-mediated tachycardia, 7 patients had had a first onset of tachycardia during pregnancy (relative risk ratio 0.86, confidence interval 0.4 to 1.9, p = 0.35). In the 100 patients with atrioventricular nodal reentrant tachycardia, 1 patient had had the first onset of tachycardia during pregnancy (relative risk ratio 0.11, confidence interval 0.02 to 0.56, p = 0.004). Otherwise, 14 of the 63 patients (22%) with tachycardia in the pregnant and nonpregnant periods had exacerbation of symptoms during pregnancy. Thus, first onset of paroxysmal SVT during pregnancy was rare (3.9%), and pregnancy was associated with a low risk of first onset of paroxysmal SVT. However, symptoms of paroxysmal SVT were exacerbated during pregnancy in some patients.

Adolescent↗

PubMed1977

Pregnancy and delivery in penicillamine treated patients with Wilson's disease.

Pregnancy and delivery of two patients with Wilson's disease are reported. Case 1 was a 20-year-old housewife who had been taking D-penicillamine fore more than 10 years and had remained asymptomatic except an episode of dissociative reaction. She apparently survived longer than any of her three sisters who died of the same disease. She discontinued the use of D-penicillamine by herself when she was at the 22nd week of pregnancy. Case 2 was a 32-year-old housewife who developed an episode of mental disorder of short circuit reaction type with mild neurological symptoms and Kayser-Fleischer rings after the prolonged interval of medication since the first pregnancy and delivery. Three months after the complete recovery of neuropsychiatric symptoms she was at the 12th week of pregnancy and withheld penicillamine from herself. During the pregnancy they had not revealed any exacerbation in terms of clinical and laboratory findings. Each of them was delivered of a healthy baby. Although the pregnancy and delivery of both patients were successful, the authors recommended that they should not prolong the interval of medication to protect themselves against the onset or relapse of the illness.

Adult↗

PubMed1999

Effect of time interval from insemination to first cleavage on the developmental characteristics, sex ratio and pregnancy rate after transfer of bovine embryos.

In vitro produced bovine zygotes show substantial variation in the time required to complete the first cell cycle and in their in vitro development potential. A number of reports have highlighted the fact that the fastest developing embryos in vitro are most likely to be comparable with their in vivo counterparts. At 24 h after IVF, presumptive zygotes were cultured in droplets of synthetic oviduct fluid medium. Droplets were examined at regular intervals and all cleaved embryos at each time point were transferred into new droplets and cultured separately for the duration of the experiment. All uncleaved zygotes were returned to the incubator and re-examined at the successive time points until 48 h after insemination, at which time the remaining uncleaved oocytes were retained as a group. A representative number of day 7 blastocysts from zygotes that had cleaved by 30 or 36 h were transferred to synchronized recipients and pregnancy was diagnosed by ultrasonography at day 35. Glucose and glutamine metabolism was examined in zygotes and blastocysts and compared retrospectively with time of first cleavage. A representative number of blastocysts from each of the cleavage groups was sexed using PCR. Data were analysed by chi-squared and regression analysis. Development to the blastocyst stage decreased as the time from insemination to first cleavage increased (r = 0.97, P < 0.03). There was no difference in blastocyst hatching, number of blastocyst cells or pregnancy rate between the 30 and 36 h groups. The overall sex ratio was 62% males (n = 258, P < 0.0001) and was not different in the 30 and 36 h groups (61%, n = 155 versus 63%, n = 95, respectively). These results indicate that although time of first cleavage has a major influence on the probability of an embryo developing to the blastocyst stage, once that stage is attained, subsequent developmental characteristics are unrelated to the time of first cleavage.

Animals↗

PubMed2002

Interval delivery and aggressive tocolysis in high-order multiple gestation. A report of three cases.

BACKGROUND: High-order multiple pregnancy (four and above) should be avoided if at all possible. The major fetal risk of high-order multiple gestation is that of extreme prematurity. Interval delivery has been used with twin and triplet pregnancies. CASES: An octuplet, sextuplet and quadruplet pregnancies were managed with interval delivery. The interval from delivery of the first infant to the remainder of pregnancy was 12 days for the octuplet pregnancy, 24 for the sextuplet pregnancy and 12 for the quadruplet pregnancy. CONCLUSION: In high-order multiple pregnancy, delayed interval delivery is strongly recommended, provided that there are no signs of chorioamnionitis, fetal distress or maternal compromise.

Adult↗

PubMed2005

Prepregnancy exposure to cigarette smoking and subsequent risk of postmenopausal breast cancer.

OBJECTIVE: To examine the association of cigarette smoking before first pregnancy with risk of postmenopausal breast cancer in a large population-based cohort. PATIENTS AND METHODS: The Iowa Women's Health Study is a prospective cohort study of 55- to 69-year-old women at baseline in 1986. In January 1986, a questionnaire was mailed to 99,826 postmenopausal women to Identify risk factors for cancer and other chronic diseases; 41,836 women responded (42.7% response rate). The primary analyses examined the associations among smoking, parity, age at first birth, and postmenopausal breast cancer. RESULTS: Of the 37,105 women in the cohort at risk, 7095 (19%) and 4186 (11%) initiated smoking before and after first pregnancy, respectively, and 2017 breast cancers were identified before December 31, 1999. Compared with parous women who never smoked, women who began smoking after their first full-term pregnancy were not at increased risk of postmenopausal breast cancer (multivariate-adjusted risk ratio, 1.03; 95% confidence interval, 0.88-1.21). However, women who began smoking before their first pregnancy had a slightly elevated risk of breast cancer (risk ratio, 1.21; 95% confidence Interval, 1.07-1.37). Results were not attenuated by adjustment for age at first pregnancy or number of live births. CONCLUSION: These data suggest that cigarette smoking is associated with a slightly greater risk of postmenopausal breast cancer for women who started smoking before their first full-term pregnancy.

Age Factors↗

PubMed2005

[Treatment of chronic bovine endometritis and factors for treatment success].

In a controlled field trial, 178 dairy cows with chronic endometritis and at least 21 days in lactation were randomly assigned to four different treatment groups: prostaglandin F2alpha intramuscularly (PG, 5 mg dinoprost (5 ml Dinolytic), n = 51), intrauterine antibiotics (AB; 400 mg ampicillin + 800 oxacillin (20 ml Totocillin), n = 49), intrauterine antiseptics (AS; 100 ml 4% Lotagen, n = 50); control (C, no initial treatment, n = 28). Before treatment, uterine swabs for bacteriologic examination and blood samples for determination of serum progesterone concentrations were collected. Two weeks following the first treatment, cows were reexamined. In case no clinical cure was diagnosed, treatment was repeated and control cows were treated for the first time with one of the three treatments mentioned above. The four treatment groups did not differ with respect to the clinical cure or reproductive performance. Therefore, factors that might have an influence on clinical cure and fertility were evaluated. With increasing duration of lactation, the clinical cure after a single treatment increased significantly over all treatment groups from 59.5% (treatment before day 42 postpartum) to 79.6% (treatment following day 42 postpartum) (P < 0.05). Within the PG group, a statistically significantly higher cure rate after a single treatment and first service conception rate and a lower pregnancy index were obtained when the treatment was performed following day 42 postpartum (P < 0.05). This was not the case in the other treatment groups. A retarded involution of the uterus based on the size had a negative effect on clinical cure over all groups (first treatment clinical cure: 68.2% (small uteri) vs 44.4% (large uteri); P < 0.05). Within groups, this effect was also detected, but only as a trend (P > 0.05). Isolation of Arcanobacterium (A.) pyogenes negatively influenced first treatment clinical cure over all treatment groups (79.0% vs 31.5%) and within treatment groups (P < 0.05). In the AB group, the pregnancy index, days open and the interval from first insemination to conception increased compared with the other treatment groups, when A. pyogenes was detected. Isolation of unspecific bacteria and the presence or absence of a corpus luteum only had minor effects over all and within the PG, AS and C group. Within the AB group, presence of luteal tissue was connected with a higher pregnancy index and increased days open and interval from first insemination to conception (P < 0.05). A multivariate analysis revealed that the presence of A. pyogenes and no initial treatment (control group) had a statistically significant independent and negative influence on the first treatment clinical cure. Ill-smelling vaginal discharge and no treatment had a negative independent effect on first service conception rate. Furthermore, days open were negatively influenced by the interval from calving to first examination and the presence of ill-smelling vaginal discharge. In conclusion, under the conditions of this field study, it seems preferrable to treat chronic endometritis. However, under the condition of a herd health program with continuous observation of sick and healthy animals, a wait-and-see attitude might also be justified.

Ampicillin↗

PubMed2005

The biologic error in gestational length related to the use of the first day of last menstrual period as a proxy for the start of pregnancy.

OBJECTIVE: In a large unselected population of normal spontaneous pregnancies, to estimate the biologic variation of the interval from the first day of the last menstrual period to start of pregnancy, and the biologic variation of gestational length to delivery; and to estimate the random error of routine ultrasound assessment of gestational age in mid-second trimester. STUDY DESIGN: Cohort study of 11,238 singleton pregnancies, with spontaneous onset of labour and reliable last menstrual period. The day of delivery was predicted with two independent methods: According to the rule of Nägele and based on ultrasound examination in gestational weeks 17-19. For both methods, the mean difference between observed and predicted day of delivery was calculated. The variances of the differences were combined to estimate the variances of the two partitions of pregnancy. RESULTS: The biologic variation of the time from last menstrual period to pregnancy start was estimated to 7.0 days (standard deviation), and the standard deviation of the time to spontaneous delivery was estimated to 12.4 days. The estimate of the standard deviation of the random error of ultrasound assessed foetal age was 5.2 days. CONCLUSION: Even when the last menstrual period is reliable, the biologic variation of the time from last menstrual period to the real start of pregnancy is substantial, and must be taken into account. Reliable information about the first day of the last menstrual period is not equivalent with reliable information about the start of pregnancy.

Cohort Studies↗