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Factors affecting walking activity at estrus during postpartum period and subsequent fertility in dairy cows.

The postpartum period is critical for efficient reproduction, and certain features of the normal estrus cycle during this period have been associated with subsequent reproductive performance. The objectives of the present investigation were to evaluate the effects of environmental, production, and reproductive factors on walking activity at estrus as determined using pedometers during the first 50 days in milk (DIM) (study 1). In a second study, we tried to establish whether pedometer measurements recorded during this period could be used to predict subsequent fertility by considering the number of cows becoming pregnant before 90 DIM. We analyzed data derived from 995 parturitions in a single herd. Detection of estrus was performed using a pedometer system. Variables were screened for associations with walking activity by analysis of variance (ANOVA) through generalized linear model procedures (PROC GLM). Increased milk production and parity, and a mean relative humidity (RH) higher than 95% were associated with lower pedometer measurements. A higher number of animals simultaneously in estrus rendered higher pedometer readings. No significant effects of the year, season, DIM, number of previous estruses, and climatic data other than high mean RH were observed. Relationships between pedometer measurements and other variables recorded during the first 50 days postpartum, and subsequent fertility were assessed by applying logistic regression models. We detected no significant effects of year, milk production, season, and mean activity increase at estrus on high fertility. The likelihood of pregnancy before 90 DIM decreased for each additional lactation and for cows in anestrus between days 0 and 50 postpartum. However, pedometer readings during the first 50 days postpartum were unable to accurately predict subsequent fertility.

Analysis of Variance↗

Plasma concentration of atrial natriuretic peptide and brain natriuretic peptide during normal human pregnancy and the postpartum period.

Increases in blood volume are observed during normal gestation and these are reversed shortly after delivery. Although both atrial (A-type) natriuretic peptide (ANP) and brain (B-type) natriuretic peptide (BNP) have been described, the role of these peptides in pregnancy and the postpartum period are unclear. This study was designed to examine the effects of pregnancy, labour and delivery on plasma levels of ANP and BNP. Plasma levels of ANP and BNP were determined during normal pregnancy, 30 min after separation of the placenta (immediately postpartum) and between 5 and 72 h postpartum (late postpartum; puerperium). Since the assay sensitivity was 20 pg/ml plasma (for both ANP and BNP), values less than this were assigned a value of 20 pg/ml to calculate means. Plasma levels of ANP and BNP were significantly higher at term pregnancy than during the first trimester (ANP increased from 20 +/- 0.2 to 57 +/- 10 pg/ml (S.E.M.), P < 0.001; BNP increased from 25 +/- 2 to 49 +/- 9 pg/ml, P < 0.01). The plasma level of ANP then rose to 157 +/- 38 pg/ml 30 min after separation of the placenta, being significantly (P < 0.01) higher than that seen at term pregnancy. It declined significantly (P < 0.001) to 32 +/- 3 pg/ml in the late postpartum period. In contrast, the plasma level of BNP 30 min after separation of the placenta was 80 +/- 25 pg/ml, and increased to 116 +/- 17 pg/ml in the late postpartum period, significantly (P < 0.01) higher than the level at term pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

An Update on Mood and Anxiety Disorders During Pregnancy and the Postpartum Period.

Because women in the childbearing years are vulnerable to mood and anxiety disorders, physicians in all patient care specialties need to be familiar with the prevalence and course of these disorders, particularly during pregnancy and the postpartum period. Systematic prospective data are limited on the onset of mood and anxiety disorders during pregnancy and the postpartum period as well as on the risk of relapse during these time periods in women with prior histories of the disorders. The literature on mood and anxiety disorders during pregnancy is frequently complicated by the use of various methodologies, procedures, and study populations, and inconsistencies in the postpartum time frame (up to 6 months after delivery) make the literature on epidemiology of postpartum disorders difficult to interpret. This article is an update of available information about the prevalence and course of mood and anxiety disorders in women during pregnancy and the postpartum period.

Journal Article↗

[Associated factors to abnormal glucosylated hemoglobin in the postpartum period].

OBJECTIVE: To demonstrate the association between risk factors and abnormal glucosylated hemoglobin detected in women during the postpartum period. PATIENTS AND METHODS: A case and control study was carried out at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca during six months. Glucosylated hemoglobin and glucose concentration from 160 fasting women with a pregnancy > or =28 weeks was obtained during the postpartum period. With an odds ratio and confidence interval (95%) the epidemiological meaning of risk factors was identified. RESULTS: The abnormal glucosylated hemoglobin was significantly associated to: single, separated and divorced women (p < 0.05); major frequency of previous caesarean (OR: 2.78, IC 95%:1.25-6.22), p = 0.006, and higher proportion of children with congenital malformations (OR: 12, IC 95%: 1.38-104), p = 0.01. In the group cases 48% of caesareans was associated to probable gestational diabetes: moderate preeclampsia, eclampsia, fetal macrosomy, and preterm deliveries. CONCLUSION: It is necessary to make an early detection of risk factors associated to abnormal glucosylated hemoglobin and to prevent adverse effects as congenital malformations and clinical complications that increase the incidence of caesarean.

Adult↗

Secretion of inhibin A and inhibin B throughout pregnancy and the early postpartum period in chimpanzees.

Plasma concentrations of inhibin A and inhibin B during pregnancy and early lactation in chimpanzees were determined by enzyme-linked immunosorbent assay (ELISA). Plasma samples were taken from five pregnant chimpanzees at 6-9, 10, 20 and 25 weeks of pregnancy, and following parturition. Throughout pregnancy and the early postpartum period, circulating inhibin A and inhibin B concentrations remained low, at similar levels to those during the normal menstrual cycle in chimpanzees. Concentrations of inhibin A in the placental homogenate were high enough to be measured by the ELISA and by bioassay, whereas circulating inhibin bioactivities in late pregnancy were too low to be measured. Plasma concentrations of FSH remained low with no significant changes throughout pregnancy and the postpartum period. Plasma concentrations of oestradiol-17beta and progesterone at 25 weeks of pregnancy were much higher than normal menstrual cycle levels. It was concluded that in chimpanzees the levels of circulating inhibin A and inhibin B remained low throughout pregnancy and the early postpartum period, and that the concentrations of bioactive dimeric inhibin did not increase towards the end of pregnancy. The suppression of circulating FSH levels during pregnancy is suggested to be controlled by steroid hormones that increased significantly in late pregnancy, and the present findings further suggest that the secretory pattern and role of inhibin during pregnancy in chimpanzees may be different from that in human and other primates.

Animals↗

The role of the mode of delivery in the alteration of intrapartum pathological cervical cytologic findings during the postpartum period.

OBJECTIVE: The aim of the study was to determine whether abnormal antepartum cervical cytologic findings change in the postpartum period and the relation of this alteration to the mode of delivery. STUDY DESIGN: Between 1991 and 2000, 192 pregnant women with antepartum abnormal cervical cytology were identified; complete demographic, clinical and cytologic reports were available for 90 of them. Papanicolaou smear tests were collected and separated in three groups using the Bethesda classification system (ASCUS, L-SIL and H-SIL). RESULTS: Of the 90 women, 52 (61.1%) were delivered vaginally and 38 (38.9%) by cesarean section. No difference was found between women delivered vaginally and those delivered by cesarean section, regardin age, parity and smoking history. The overall postpartum regression rate for the 20 women with antepartum H-SIL cells was 45%. Of the 12 women with H-SIL cells who were delivered vaginally, eight (66.6%) showed regression in the postpartum period while this regression was achieved only in one (12.5%) woman, who was delivered by cesarean section (p < 0.002). CONCLUSION: Postpartum spontaneous regression of suspicious Papanicolaou smears consistent with H-SIL occurs with increased frequency among women who are delivered vaginally compared to those delivered by cesarean section.

Adult↗

Thyroid function during pregnancy and the postpartum period: iodine metabolism and disease states.

OBJECTIVE: To review various aspects of thyroid function during and early after pregnancy. METHODS: We discuss biochemical and potential pathologic changes in the thyroid associated with the gestational and postpartum periods. RESULTS: Urinary iodine excretion during the last trimester of gestation in healthy euthyroid women shows that, in areas with mild iodine intake, iodine supplementation is necessary during pregnancy and the postpartum period. This measure should be considered in iodine-sufficient areas as well. Thyroglobulin is the main biochemical marker of persistent thyroidal stimulation. Alterations in thyroid volume during pregnancy can persist after delivery, especially in breast-feeding mothers. In most patients, the goitrogenic stimulus of pregnancy can be suppressed with iodine supplementation. Autoimmune thyroid disease during pregnancy and the postpartum period is reflected by monitoring of thyroid peroxidase antibodies (TPO-Ab). Women with positive test results for TPO-Ab early in gestation showed a highly significant decrease in free thyroxine and increased thyroid-stimulating hormone levels late in gestation. The main marker of Graves' disease during pregnancy is thyroid-stimulating antibodies. Nonautoimmune gestational hyperthyroidism differs from Graves' disease in that thyroid-stimulating antibodies are not detectable. CONCLUSION: Clinicians should be alert to the fact that pregnancy can induce thyroidal pathologic conditions.

Journal Article↗

Calcium absorption is significantly higher in adolescents during pregnancy than in the early postpartum period.

BACKGROUND: Early childbearing may limit skeletal consolidation and increase calcium demands in adolescents. OBJECTIVE: The purpose of this study was to characterize calcium absorption in pregnant and lactating adolescents. DESIGN: Fractional calcium absorption was evaluated in 23 adolescents (mean +/- SD age: 16.5 +/- 1.4 y) during the third trimester of pregnancy (34.7 +/- 1.0 wk gestation) and again in 15 of these adolescents 31 +/- 8 d after delivery. Eight adolescents were breastfeeding their infants during the follow-up study. Fractional calcium absorption was determined by using oral ((46)Ca or (44)Ca) and intravenous ((42)Ca) stable calcium isotopes. Total-body and lumbar spine bone mineral density were measured in adolescents during the postpartum period by using dual-energy X-ray absorptiometry. RESULTS: Fractional calcium absorption was significantly greater during pregnancy than at 3-4 wk postpartum [0.526 +/- 0.152 (n = 23) compared with 0.297 +/- 0.108 (n = 15); P < 0.0001]. Lumbar spine z scores measured 19-44 d after delivery (n = 15) were significantly associated with calcium intake during pregnancy (y = -3.53 + 0.107x; R(2) = 0.355, P < 0.02) and were inversely related to fractional calcium absorption during pregnancy (y = 3.489 - 6.66x; R(2) = 0.52, P = 0.002). A total of 33% (5/15) of adolescents had lumbar spine z scores that met the definition of osteopenia (n = 3) or osteoporosis (n = 2) in the early postpartum period. CONCLUSIONS: Calcium absorption in adolescents was significantly higher during the third trimester of pregnancy than in the early postpartum period, and higher calcium intakes during pregnancy appeared to be protective against loss of trabecular bone at the lumbar spine.

Absorptiometry, Photon↗

Body mass index, eating attitudes, and symptoms of depression and anxiety in pregnancy and the postpartum period.

OBJECTIVE: This report describes associations between body mass index (BMI; kg/m2), eating attitudes, and affective symptoms across pregnancy and the postpartum period in a sample of 64 women. METHODS: As part of a larger study, women were recruited during pregnancy and followed prospectively to 14 months postpartum. Measures included self-reported prepregnancy and 4-month postpartum BMI as well as pregnancy, 4-month, and 14-month postpartum eating attitudes (EAT), depressive symptoms (CES-D), and anxiety symptoms (STAI). RESULTS: During pregnancy, symptoms of depression or anxiety were not significantly correlated with concurrent eating attitudes or measures of BMI. However, at 14 months postpartum, measures of eating attitudes and both depression and anxiety symptoms were associated. Measures of BMI were associated with depressive and anxiety symptoms at both 4 and 14 months postpartum. Four-month eating attitudes and BMI predicted 14-month postpartum depressive symptoms, beyond pregnancy, and 4-month postpartum measures of affective symptoms. Results suggested that overweight women were at risk for elevated anxiety at 4 months and depressive symptoms at both 4 and 14 months postpartum. CONCLUSIONS: These results provide evidence for a significant, albeit moderate, relationship between BMI, eating attitudes, and symptoms of depression and anxiety in the postpartum period that are not present during pregnancy.

Adult↗

Changes in hypothalamic and pituitary content of immunoreactive alpha-melanocyte-stimulating hormone during the gestational and postpartum periods in the rat.

alpha-Melanocyte-stimulating hormone (alpha-MSH) was measured in the mediobasal hypothalamus (MH), median eminence (ME), preoptic-suprachiasmatic area (POA-SCN), anterior (AL), and posterior lobes (PL) of the pituitary gland during the gestational and postpartum periods in the rat. The content of alpha-MSH in the MH and POA-SCN compared to estrous levels was lower during the later days of gestation and decreased further in the MH during lactation in association with the elevated plasma prolactin (Prl). Distinct increases in the ME content of alpha-MSH compared to estrous levels occurred on Days 8 and 12 of the gestational period and Day 14 of the postpartum period. A significant increase in PL content of alpha-MSH compared to Days 5-11 and 17-20 occurred on Day 4 of gestation, and no significant changes were detected in the AP concentration of alpha-MSH throughout the period studied. In vitro, PLs and ALs from females on Day 4 of gestation secreted more alpha-MSH into the incubation medium than tissues from animals on Day 20. These results suggest that alpha-MSH of both brain and pituitary origin may play a role in mediating some of the physiological changes which occur during pregnancy and lactation.

Animals↗

[Random comparative study between intrauterine device Multiload Cu375 and TCu 380a inserted in the postpartum period].

OBJECTIVE: To evaluate safety and effectiveness of the intrauterine device Multiload Cu375 compared with the TCu 380A inserted in the postpartum period. PATIENTS AND METHODS: In a randomized comparative study carried out in the National Perinatology Institute, intrauterine devices MLCu 375 and Tcu 380A were inserted to 157 patients who voluntary accepted, and previously signed informed consent. There were four instances for the intrauterine devices insertion: within 10 minutes after vaginal delivery, during cesarean section (immediate postplacental insertion) and postpartum-postcesarean insertion (in the time range of 10 min to 48 h). All insertions were made with ring forceps. From 1 h to 24 h later, abdominal ultrasound examinations were performed to assess the distances between the upper part of the device to the fundus of uterine cavity. Follow up visits were scheduled at 3, 6, 9 and 12 months. Net cumulative life table event rates of discontinuations were estimated at one year. RESULTS: The expulsion rates were 10.4 for the MLCu 375 and 7.7 for the TCu 380A and they were not influenced by the moment of the intrauterine device insertion, not by the cervical dilatation, neither by the distance of the intrauterine device to the fundus of uterine cavity. The removal rates for bleeding and pain were 4.9 and 4.8, the removal rates for non medical reasons were 3.7 and 4.9 respectively. There was one case of genital infection in the MLCu 375 group. There were no pregnancies, nor uterine perforation. The one year continuation rates were 77.1 and 82.6 respectively. There were no statistical significant differences in the comparative rates. CONCLUSIONS: The intrauterine device MLCu 375 is as safe and effective as the TCu380A when they are inserted in the postpartum period.

Adult↗

Effect of seasonal conditions on oestrus occurrence and postpartum period in Anatolian water buffaloes.

Oestrus and calving records of Anatolian buffaloes were analyzed to investigate influence of climatic conditions on oestrus occurrence and postpartum period. Oestrus records showed a seasonal pattern concentrated between July and September which is the warmest period of the year. Likewise, more than half (52.7%) of the total calvings occurred between May and August. Month of calving significantly influenced the length of calving to first oestrus interval and open period (P < 0.01). The average length of open period was significantly shorter in autumn and summer calvers compared to those calved in spring and winter (P < 0.05) during long days. The humidity rate was negatively correlated with both calving to first oestrus interval and open period (P < 0.05). In conclusion, exposure to high environmental temperatures around 20 degrees C exerted no suppressive influence on ovarian activity in Anatolian buffaloes. Although humidity rate (P < 0.05) and ambient temperature (P < 0.01) was found to be correlated with the duration of postpartum period, day length might be the main factor regulating reproductive biorhythm and postpartum events in Anatolian buffalo cows.

Animals↗

Urinary steroids in the periparturient and postpartum periods through early pregnancy in llamas.

Urinary steroids were determined daily in the periparturient and postpartum periods, including early pregnancy, in the female llama. Estrone sulfate (E(1)S) and pregnanediol glucuronide (PdG) concentrations were determined by enzyme immunoassay with values corrected for variations in urine concentration by creatinine. Estrone sulfate concentrations, elevated during the last 20 days of gestation through 12 hours before parturition, were declining at the time of delivery. Pregnanediol glucuronide concentrations followed a pattern similar to that of estrone sulfate except that values began to decrease 5 days before parturition. Values for both E(1)S and PdG were basal by 24 hours after delivery. The first significant elevation of estrone sulfate, indicative of initial follicle development, was observed 5 days after parturition. Pregnanediol glucuronide concentrations were low during the postpartum period until 4 to 5 days after breeding. The PdG values rose steadily following copulatory-induced ovulation, which was initiated at about 2 weeks postpartum; values continued to increase through the first 15 days of pregnancy.

Journal Article↗

[HELLP syndrome in the postpartum period].

The HELLP syndrome was described by Weinstein as a complication of pregnancy induced hypertension (PIH). There are few clinical reports about HELLP during postpartum period. We present the history of 31 years old pregnant patient, who developed in 36 week of her first pregnancy PIH, pregnancy was terminated in 39 week by cesarean section and postpartum period was complicated with HELLP syndrome (class I). The patient was treated surgically (hysterectomy), than continue at ICU. The treatment was successful without any late organ complications.

Adult↗

Efficacy of the kampo medicine xiong-gui-tiao-xue-yin (kyuki-chouketsu-in), a traditional herbal medicine, in the treatment of maternity blues syndrome in the postpartum period.

This study was to evaluate the clinical efficacy of Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in), a Japanese traditional herbal medicine, in stabilizing postpartum psychological state. We enrolled 268 women who had a normal delivery in Osaka Medical College Hospital or its affiliated clinics and randomly assigned them to the following two groups: a group of 134 women who received Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) at a dose of 6.0 g/day and another group of 134 women without Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) (control group). We observed 2.06-fold and 1.67-fold higher incidences of depressive mood and nervousness, respectively, after delivery in the control group than in the Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) group. Within 3 weeks of postpartum, there was a significant difference in the incidences of maternity blues between the Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) group (15.7%; 21/134) and the control group (32.1%; 43/134) (p = 0.0195). No adverse effects were observed in this study. The results of this study demonstrate the beneficial clinical effects of Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) in stabilizing psychological state in the postpartum period. Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) can be expected to improve the mental health of women in the postpartum period and prevent maternity blues.

Adult↗

Changes in natural killer cell activity in normal pregnant and postpartum women: increases in the first trimester and postpartum period and decrease in late pregnancy.

Changes in the activity and number of natural killer (NK) cells in peripheral blood in normal pregnant and postpartum women were examined. NK activity was measured in a 4-h 51Cr-release assay and evaluated by conventional relative lytic units and absolute lytic units which represent the total NK activity within a fixed volume of circulating blood. The number of NK cells was analyzed with FITC-conjugated monoclonal antibodies and by use of an automated flow cytometer. Unexpectedly, the relative NK activity increased in the first trimester and also for 1 month postpartum compared to the activity in normal non-pregnant controls. On the other hand, absolute NK activity decreased in the third trimester compared to the activity in normal non-pregnant controls. The percentage of CD57+ cells decreased in the second trimester, but the percentage of CD16+ cells did not change during pregnancy or the postpartum period. The absolute counts of CD57+ cells and CD16+ cells decreased in the second and third trimesters and increased transiently in the postpartum period. These findings indicate that the increased NK activity in the first trimester and at 1 month postpartum is induced by increased cytotoxic activity of individual NK cells, and that the decreased NK activity in late pregnancy is induced by a decrease in the numbers of NK cells. These physiological changes may play an important role in implantation in early pregnancy, protection of the fetal allograft in late pregnancy and in the natural defense against infection during the puerperal period.

Adult↗

Natural family planning: postpartum period.

The length of the postpartum anovulatory period was studied in 200 mothers by means of endometrial biopsy, basal body temperature, vaginal cytology, and cervical mucus. The occurrence of the first ovulation and the first bleeding after childbirth are analyzed in relation to the type of nursing. The characteristics of 408 postpartum menstrual cycles are studied, by means of the same methodology. The shortest anovulatory period for nonnursing mothers was 36 days; for partial nursing mothers, 40 days; and for full nursing mothers, 70 days. The first postpartum bleeding appeared to be preceded by ovulation in 41% of the full nursing mothers, 75% of partial nursing mothers, and 91% of nonnursing mothers. Postpartum cycles were significantly longer and showed a luteal phase significantly shorter than control cycles, especially when the mother was fully nursing.

Biopsy↗

Factors affecting fertility according to the postpartum period in crossbred dual-purpose suckling cows in the tropics.

To determine the relationship between first service conception rate (FSC) and the postpartum period (PP), 6160 calvings from 2250 crossbred dual-purpose cows were analysed. The effects of breed predominance (BT: Bos taurus and BI: Bos indicus), season of service (dry, intermediate and humid), parity (1 or 2 and more), agroecological region (Sub-humid and Dry Tropical Forest) and milk production were studied. The postpartum period was grouped according to the calving-first service interval as G1 < or = 60 days (n = 1889); G2 > 60 < or = 90 days (n = 1436); G3 > 90 < or = 120 days (n = 1030); and G4 > 120 days (n = 1805). Data were analysed by chi-squared test. The overall mean for FSC was 58.2% and was lower in G1 (p < 0.01). All PP showed a breed effect on FSC, with mean values of 61.6% and 53.3% for BI and BT, respectively. Season of service also affected FSC, which was significantly lower during the humid period: 51.2% versus 57.4% and 61.5% for the intermediate and dry periods (p < 0.01), respectively. Parity and environmental effects were not observed on FSC. Levels of milk yield did influence the FSC, which decreased from 66.7% and 61.0% for milk yields of < 1500 kg and between 1501 and 2000 kg to 46.0% in milk yields > 2000 kg (p < 0.01).

Animals↗