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At least 109 records · Page 6Linked to original sources

PubMed2000

Risk of spontaneous abortion following induced abortion is only increased with short interpregnancy interval.

We set out to study the risk of spontaneous abortion following a first trimester induced abortion as a function of the interpregnancy interval between two pregnancies. The cohort study is based on the following databases: Danish national registries: the Medical Birth Registry (MBR), the Hospital Discharge Registry (HDR), and the induced Abortion Registry (IAR). All primigravid women in the time period from 1980 to 1982 were identified in the MBR, the HDR and the IAR. A total of 15 727 women who terminated the pregnancy with a first trimester induced abortion were selected as the induced abortion cohort, and 46 026 women who did not terminate the pregnancy with an induced abortion constituted the control cohort. By register linkage all subsequent pregnancies which were not terminated by induced abortion were identified from 1980 to 1994. Only women who had a non-terminated pregnancy following the index pregnancy were selected. Women whose first pregnancy was terminated following a first trimester induced abortion had a risk of spontaneous abortion of 11.0% vs. 9.4% in the control cohort. This relative difference of 1.17 was not statistically significant in logistic regression analyses. An increased risk was only found for women who had an interpregnancy interval of less than 3 months (OR=4.06, 95% C.I.=1.98-8.31). The abortion method, vacuum aspiration with dilatation or evacuation with dilatation did not modify this elevated risk. Overall the study did not show an increased risk of spontaneous abortion following one or more induced abortions, except for women with a short interpregnancy interval between an induced abortion and a subsequent pregnancy. We recommend women who have a first trimester induced abortion be advised to wait at least 3-6 months before trying to become pregnant again.

Journal Article↗

PubMed1994

Reproductive performance of dairy cows following treatment with fenprostalene, dinoprost, or cloprostenol between 24 and 31 Days post partum: a field trial.

Three hundred and one Holstein cows (n=301), calving at a commercial free-stall dairy farm, were randomly assigned to 1 of 3 prostaglandin treatment groups or a placebo group. The placebos were packaged 3 ways to mimic the 3 commercial prostaglandin preparations. Group 1 received 1 mg fenprostalene and 1.6 mg oxytetracycline; Group 2 received the fenprostalene placebo (2 ml polyethylene glycol and 1.6 mg oxytetracycline); while Group 3 was given 25 mg dinoprost. Group 4, the dinoprost placebo received 5 ml saline; Group 5 received 500 microg cloprostenol; and Group 6 the cloprostenol placebo received 2 ml saline. The treatments were administered between Days 24 and 31 post partum. Double blind techniques were used in administering treatments and in assessing the response to treatment. There were no significant differences among treatment groups with respect to incidence of retained fetal membranes, endometritis, pyometra, anestrus, number of services per pregnancy, calving-to-first estrus interval, services per conception, number of prostaglandin treatments other than those administered between Days 24 and 31 post partum, the percentage culled for reproductive reasons and all factors combined. Cows receiving fenprostalene, dinoprost or cloprostenol had a decreased calving-to-conception interval compared with that of the controls (P = 0.05). It is concluded that, in the herd studied, treatment with any of the 3 commercially available prostaglandin products between Days 24 and 31 post partum was beneficial for reproductive performance.

Journal Article↗

PubMedDate not supplied

[Examination of mammography records. Retrospective study of patients examined in the decade 1967-1976].

A retrospective study has been made of mammography data with a view to identifying and analysing a number of epidemiologico-clinical and socio-medical factors involved in the problem of breast cancer. Particular attention was paid to the existence of risk indicators related to malignant cancer of the breast. Routine statistical tests on the data showed that patients with breast cancer differ from other women (healthy or with benign neoplasia, or dysplasia, or suspected malignity, or inflammation) because of the higher frequency of certain features such as the high average age, late menopause, early menarche, longer interval between menarche and first term pregnancy, family history of malignant cancer of all types and of exclusively breast localization. This analysis proved to be in agreement with other data reported in the literature, however, a number of factors considered to be risk indicators were not found: i.e. absence of pregnancy, absence of breast feeding and reduction in the total breast feeding time.

Adult↗

PubMed1998

Prenatal diagnosis of congenital toxoplasmosis transmitted by an immunocompetent woman infected before conception. Reims Toxoplasmosis Group.

We report a rare case of congenital toxoplasmosis transmitted by an immunocompetent woman infected before conception. Active toxoplasmosis was suspected due to persistent lymphadenitis with specific IgM, IgA, IgE antibodies. Prenatal diagnosis based on amniocentesis and fetal blood sampling at 24 weeks' amenorrhoea was positive on amniotic fluid, and fetal infection was confirmed after termination. In our opinion such cases need the same monitoring as when seroconversion occurs during the first trimester. A pregnancy-free interval of six to nine months is recommended after proven patent toxoplasmosis seroconversion.

Adult↗

PubMed1981

Relationship between early pregnancy site in consecutive gestations in mares.

The records of 200 pairs of consecutive pregnancies in mares showed that in 82 per cent of cases the second pregnancy was initially established in the opposite uterine horn to that of the first, irrespective of the parturition to conception interval. This relationship also occurred when the first pregnancy ended in abortion after 140 days but not if it terminated before this time.

Animals↗

PubMed1999

Delayed interval delivery in multiple gestations.

The incidence of higher-order gestations is increasing primarily as a result of menstrual cycle manipulation, with concomitant increased risk in maternal and fetal complications. Perinatal mortality rates range between 47 and 120 per 1000 births for twins and 93 to 203 per 1000 births for triplets. The critical period of perinatal mortality and morbidity is between weeks 23 and 28 of gestation. Attention has recently turned to methods of delaying the birth of second and higher order fetuses to improve newborn survival and decrease neonatal morbidity in these high-risk pregnancies. We report two cases of delayed interval delivery. Neither pregnancy involved a monochorionic/monoamniotic gestation. The first case was a twin gestation delivered at 21 weeks with an interval of 5 days and extreme prematurity of both twins. The second case was a triplet gestation delivered at 21 weeks with an interval of 5 days. Triplet A was stillborn; triplets B and C succumbed in extreme prematurity. Preterm labor in multiple gestations usually results in delivery of all fetuses. On occasion, the uterus will spontaneously cease to contract after the birth of one or more premature infants. Review of the literature now reports 48 twin pregnancies exposed to delayed interval delivery with 40 surviving infants of 96 fetuses. Whereas delaying the delivery of remaining fetuses improves their prognosis, there is currently no consensus regarding technique nor is there statistical significance in techniques currently used. Furthermore, study is indicated to reduce preterm birth and associated costs.

Adult↗

PubMed1990

Pregnancy and the risk of developing rheumatoid arthritis.

There have been conflicting reports on, and no plausible biologic explanation for, a protective effect of oral contraceptive (OC) use on the development of rheumatoid arthritis (RA). Therefore, we investigated aspects of behavior related to OC use that could explain the preventive effect of OC on the onset of RA. In the present case-control study, past pregnancy, age at first pregnancy, and pregnancies with adverse outcome were studied as possible risk factors for RA. Interview information on reproductive variables was obtained from 135 young adult women with confirmed definite or classic RA of recent onset, and from 378 control patients with soft tissue rheumatic disorders or osteoarthritis. All patients had at least 2 years of followup to confirm the consistency of the diagnosis. We found a decreased risk of RA in women who had been pregnant. The risk of RA in women who had ever been pregnant compared with women who had never been pregnant was 0.49 (95% confidence interval 0.27-0.91). The earlier the first pregnancy, the lower the risk of RA. Pregnancy with adverse outcome (i.e., gestation less than 25 weeks) did not substantially change the risk of RA (relative risk 0.73, 95% confidence interval 0.50-1.07). The protective effect of pregnancy was independent of OC use, the presence of HLA-DR4, or a family history of RA. Immune modulation by female hormonal influences could be an explanation for the results of the present study.

Adult↗

PubMed2003

Genetic parameters for body condition score, body weight, milk yield, and fertility estimated using random regression models.

Genetic (co)variances between body condition score (BCS), body weight (BW), milk yield, and fertility were estimated using a random regression animal model extended to multivariate analysis. The data analyzed included 81,313 BCS observations, 91,937 BW observations, and 100,458 milk test-day yields from 8725 multiparous Holstein-Friesian cows. A cubic random regression was sufficient to model the changing genetic variances for BCS, BW, and milk across different days in milk. The genetic correlations between BCS and fertility changed little over the lactation; genetic correlations between BCS and interval to first service and between BCS and pregnancy rate to first service varied from -0.47 to -0.31, and from 0.15 to 0.38, respectively. This suggests that maximum genetic gain in fertility from indirect selection on BCS should be based on measurements taken in midlactation when the genetic variance for BCS is largest. Selection for increased BW resulted in shorter intervals to first service, but more services and poorer pregnancy rates; genetic correlations between BW and pregnancy rate to first service varied from -0.52 to -0.45. Genetic selection for higher lactation milk yield alone through selection on increased milk yield in early lactation is likely to have a more deleterious effect on genetic merit for fertility than selection on higher milk yield in late lactation.

Animals↗

PubMed2002

Pre-eclampsia in pregnancy and subsequent risk for breast cancer.

Women who experience pre-eclampsia or hypertension during pregnancy may have a reduced risk for breast cancer later in life. The evidence is based on case-control studies, and here we report the results of a cohort study exploring the link between pre-eclampsia and gestational hypertension diagnosed in the first pregnancy and subsequent risk for breast cancer. We combined information from the Medical Birth Registry and the Cancer Registry in Norway, which are both nation-wide. Between 1967, when the birth registry was established, and 1998, 694 657 women were recorded with a first birth, and classified according to whether pre-eclampsia and/or hypertension was diagnosed in the first pregnancy. Linkage to the Norwegian Cancer Registry identified 5474 new cases of breast cancer diagnosed subsequently to their first delivery. Compared to other parous women, women with pre-eclampsia and/or hypertension diagnosed in their first pregnancy had 19% lower risk (95% confidence interval, 9 to 29%) for breast cancer, after adjustment for attained age, calendar period of diagnosis, age at first birth, and parity. This result was similar for term and preterm deliveries, across the range of offspring birth weight, and for pre- and postmenopausal women. These results suggest that the pathophysiology surrounding pre-eclampsia and gestational hypertension plays an important role in breast cancer etiology. A better understanding of the underlying processes could provide an insight into the pathogenesis of breast cancer.

Birth Weight↗

PubMed2003

Pregnancy outcomes following the diagnosis of interstitial cystitis.

OBJECTIVE: To describe the outcome of pregnancy in patients treated for interstitial cystitis. METHODS: Over a 4-year period, 12 patients with interstitial cystitis who had one course of intravesical dimethyl sulphoxide (DMSO) therapy for interstitial cystitis were studied. Information on the effects of the treatment-to-conception interval, symptom control during pregnancy and immediately post partum, other pregnancy events and pregnancy outcome were collected. RESULTS: The mean age was 32 years (SD = 5.4), and 6 (50%) were nulliparous. Fifty-eight percent of the women presented with combined urinary and pain symptoms, 25% with a pain symptom only and 17% with a urinary symptom only. Eleven women had 1 course (6 doses) of DMSO therapy. Symptom relief was maintained during pregnancy in almost all the women. The mean interval from diagnosis of interstitial cystitis to the first day of the last menstrual cycle preceding all pregnancies beyond 28 weeks was 19.3 months (SD = 14.7). This interval was 6 months or less for 2 pregnancies that were terminated on account of symptoms attributable to interstitial cystitis. Thirteen healthy babies were delivered. CONCLUSION: Pregnancy outcomes appear good following treatment for interstitial cystitis with 1 course of intravesical DMSO.

Adult↗

PubMed2002

Congenital heart block in neonatal lupus: the pediatric cardiologist's perspective.

CLINICAL PRESENTATION: Congenital heart block (CHB) in the absence of major structural abnormalities is associated with maternal antibodies to Ro (SS-A) and La (SS-B). CHB is most commonly diagnosed between 18 and 24 wk of gestation, and may be first, second or third degree (complete). Mortality approaches approximately 20%, and most surviving children require pacemakers. Affected infants may develop cardiomyopathy. Abnormalities in the skin, liver and blood of neonates are also associated with anti-Ro/La antibodies, and are usually self-limiting; these manifestations and CHB are collectively referred to as neonatal lupus syndromes (NLS). INVESTIGATION OF PATHOGENESIS: Recent studies demonstrate that Ro/La ribonucleoproteins appear on the surface of apoptotic fetal cardiocytes and are recognized by their cognate antibodies, promoting an inflammatory response. Mice immunized with Ro/La proteins have offspring with conduction abnormalities. In vitro, human serum and IgG with anti-Ro/La antibodies affect the conducting properties of isolated animal heart tissue. DIAGNOSTIC PROBLEMS: If fetal bradycardia is identified, a 2-dimensional and M-mode fetal echocardiographic and Doppler ultrasound should be obtained to determine whether there is an atrial arrhythmia or atrioventricular (AV) block, and to what degree, and whether there are major structural abnormalities of the heart. The mother's serum should be tested by ELISA for anti-Ro and/or anti-La antibodies. THERAPEUTIC OPTIONS: To date, only anecdotal and retrospective evidence guides in utero therapy of CHB. A prospective trial is currently underway to evaluate the efficacy of maternal oral dexamethasone in treating newly identified first, second or third degree block. Established third-degree block appears to be irreversible. Dexamethasone and sympathomimetics may be of some benefit in treating hydrops fetalis. In pregnant women with anti-Ro/La antibodies, prophylactic therapy is not indicated but serial echocardiographic analysis is strongly recommended, with emphasis on the mechanical PR interval to identify a reversible block. CONCLUSION: CHB occurs in approximately 1-5% of pregnancies in mothers with anti-Ro/La antibodies, independent of the mother's disease status, and in approximately 15-20% of pregnancies following the birth of a child with NLS. Treatment of CHB identified in utero is not established but guidelines are provided. Serial echocardiographic monitoring of high-risk pregnancies, using the mechanical PR interval to identify first degree block, may afford the earliest opportunities for therapeutic intervention.

Antibodies, Antinuclear↗

PubMed1996

Cytokine production in the serum and spleen of mice from day 6 to 14 of gestation: cytokines/placenta/spleen/serum.

Pregnancy, like most biologic phenomena, involves the action of cytokines. These proteins have a short half-life and are believed to exert their effect close to their site of production, where diagnostic tests cannot be easily performed. Here we show that the cytokine content in the maternal serum reflects cytokine production and secretion from maternal spleen cells, which also correlates with production from decidual cells. We show that GM-CSF, IL-3, and IL-10 are present in the serum at specific time intervals during the first half of murine pregnancy, which correlates with their production from maternal spleen cells. Purified GM-CSF and IL-3 from spleen-cell-culture supernatants are biologically active molecules, able to stimulate placental-cell proliferation. Furthermore, TNF-alpha, which has been identified in many cases of fetal rejection as well as in labor, is shown to be naturally produced during the second half of pregnancy. Additionally, within the limits of the sensitivity of the technique we have used, the detection of IL-4 and the absence of detectable levels of IL-2 in the maternal serum strongly comforts the hypothesis that pregnancy is a Th2-dependent phenomenon. The results presented in this paper show that the cytokine profile during pregnancy can be monitored by simple blood tests, which may be of relevance both in the followup of a physiological human pregnancy and to the diagnosis of recurrent abortions due to cytokine imbalance.

Animals↗

PubMed1998

Delayed first pregnancy among African-American adolescent smokers.

PURPOSE: This study aimed to compare rates of adolescent pregnancy among African-American adolescents who began smoking as adolescents with those who did not. METHODS: Cross-sectional data on 1042 primiparous African-American women enrolled in a randomized clinical trial of nurse home visitation were examined. The independent variable, adolescent smoking, was defined as a report of smoking before the age of 18 years. The outcome variable was adolescent pregnancy, defined as first pregnancy before the age of 18 years. Logistic regression was used to control for potential confounders. RESULTS: After adjustments for drug use, use of contraception, frequency of coitus, and sexually transmitted diseases, women who smoked during adolescence had a 50% lower risk of becoming pregnant as an adolescent [odds ratio of 0.46 (95% confidence interval [CI] 0.27-0.76)]. When time to first pregnancy was examined as a continuous variable, adolescent smoking was associated with a delay in pregnancy of 22.6 months (95% CI 16.8-29.2). CONCLUSIONS: Teen smoking appears to be associated with a significantly lower rate of adolescent pregnancy among African-Americans. Although the nature of this relationship is unclear, this finding suggests the need for linkage between smoking prevention and adolescent pregnancy prevention.

Adolescent↗

PubMed2000

Delayed-interval delivery: extended series from a single maternal-fetal medicine practice.

OBJECTIVE: Our purpose was to review the extended experience of a single maternal-fetal medicine practice with delayed-interval delivery. STUDY DESIGN: We completed a retrospective review of our maternal-fetal medicine practice database from January 1991 through March 1999. Patients were derived from both primary and consultative practices. All patients were managed with tocolysis, antibiotics, and cerclage after delivery of the first fetus(es). Retained siblings were investigated by amniocentesis to exclude intra-amniotic infection. RESULTS: Twenty-four consecutive patients had attempted delayed-interval delivery. Exclusion criteria for delayed-interval delivery included monochorionicity, abruptio placentae, severe preeclampsia, and the need for hysterotomy. The mean latency interval was 36 days, with a range of 3 to 123 days. Additionally, patients with previous cerclage(s) had significantly shorter mean latency intervals than patients without previous cerclage(s). Patients with long latency intervals (> or =49 days) had earlier births of the first fetus. CONCLUSION: Selected multichorionic pregnancies may benefit from delayed-interval delivery. Patients with previous cervical cerclage(s) during the index pregnancy are less likely to achieve significant latency intervals. Even modest intervals between births of siblings at critical gestational ages can improve neonatal survival and decrease neonatal morbidity.

Cervix Uteri↗

PubMed1985

Estimates of genetic correlations between testicular measurements and female reproductive traits in cattle.

Data from 528 male and 645 female progeny of 63 sires were used to estimate genetic correlations between female and male reproductive traits. Data were from two Hereford herds involved in a long-term selection program of the North Carolina Agricultural Experiment Service. Testicular measurements of circumference, diameter, length and volume were obtained on bulls at 205 and 365 d. Testicular growth measures were defined as differences between 205-and 365-d measurements. Heifers were placed in the breeding herd as yearlings and given two breeding seasons to produce a calf. Traits utilized from females were three age-at-first-breeding traits, two age-at-first-calving traits, two pregnancy rate traits, rebreeding interval and calving interval. Genetic correlations were estimated from half-sib and from sire-daughter analyses. Seventy-five percent or more of the correlations of testicular measurements with pregnancy rats, age at first breeding and age at first calving were in the favorable direction. Average correlations were .62, -.55 and -.66, respectively. For each of the remaining female traits, approximately 50% of the correlations were favorable and the average correlations were small. Correlations were summarized by testicular measurement with favorable correlations given a negative sign. Testicular diameter had more favorable correlations (80%) than length, volume or circumference (70%). However, average correlations were similar (-.31, -.30, -.34 and -.26, respectively). Testicular measurements taken at either 205 or 365 d had the same percentage of favorable correlations (72%), while testicular growth measurements had a slightly higher percentage of favorable correlations (78%). Average correlations of 365-d measures were higher (-.38) than either 205-d or growth measures (-.25 and -.28, respectively). Heritabilities for testicular measurements tended to be moderate to high, while those for female reproduction tended to be low to moderate. These results suggest that selection for increased testicular size would lead to improvement in female reproduction, particularly an increase in calving rate and a decrease in age at first breeding.

Animals↗

PubMed1992

Low birth weight in the central Canadian Arctic.

Birthing, health and prenatal records of 523 infants born between 1984 and 1988 in the central Canadian Arctic, were reviewed. The incidence of low birth weight (LBW) was 5.5%, which is lower than in many other populations. Principal indicators of risk were a previous history of a LBW infant, a short inter pregnancy interval, low weight at the time of the first prenatal visit and a weight gain of less than 200 gm/wk throughout pregnancy. Use of nicotine and alcohol may have been contributing factors. Although low, it is argued that the incidence could be further reduced through prepregnancy social and educational programs, as well as intensified prenatal care for those at risk.

Arctic Regions↗

PubMed2000

Suboptimal reproductive performance of dairy cattle kept in smallholder herds in a rural highland area of northern Tanzania.

The objectives of the present study were to assess the reproductive performance and cumulative incidence risk of reproductive disorders and to compare the success of artificial insemination (AI) to natural service (by handmating; NS) in dairy cattle kept in smallholder herds under a zero-grazing system in a rural highland area of Tanzania. Data on occurrence of all normal and abnormal reproductive events were collected for 215 adult animals belonging to 74 households. The median and range of the intervals: intercalving, calving to first service, and calving to pregnancy were 477 (335-860), 154 (38-486) and 206 (61-567) days, respectively. Breed and parity did not affect the reproductive parameters (P>0.05). However, cows in the milked group had a shorter median calving interval than those in the suckled group (P<0.001). The overall percentage pregnant and the percentage pregnant to first service were higher in the NS than in the AI group (49 vs. 32%; P=0.007) and (67 vs. 25%; P<0.001), respectively. The median numbers of services per pregnancy were not different between the AI (3) and NS (2) groups (P=0.17). The cumulative incidence risk of abortion, dystocia, prolapse, retained fetal membranes, mastitis, milk fever and cyclic non-breeders were 16.0, 1.7, 2.5, 4.2, 5.0, 1.7, and 6.1%, respectively. Hoof overgrowth (4.6%) and hoof deviation (4.6%) were the most-frequent digital problems. We concluded that reproductive parameters and cumulative incidence risk of abortion show suboptimal reproductive performance in rural-based, zero-grazed smallholder dairy herds in Tanzania particularly those using AI.

Abortion, Spontaneous↗

PubMed2000

Birth outcomes of women with ulcerative colitis: a nationwide Danish cohort study.

OBJECTIVE: Our study aimed to compare the birth outcomes in offspring of women with ulcerative colitis with controls without the disease. METHODS: A cohort study of 1531 newborns to mothers with ulcerative colitis, and 9092 controls, based on linkage between the Danish National Registry of Patients and the Danish Birth Registry from 1982 to 1992. RESULTS: Among the births to women with ulcerative colitis, 569 took place before and 962 after the first hospitalization for ulcerative colitis. We found no increased risk of either low birth weight or intrauterine growth retardation for newborns born before or after the mothers' first hospitalization. The risk of preterm birth was increased when birth occurred after the mothers' first hospitalization (odds ratio = 1.4, 95% confidence interval = 1.1-1.9), and particularly when the first hospitalization for ulcerative colitis took place during pregnancy (odds ratio = 3.4, 95% confidence interval = 1.8-6.4). CONCLUSIONS: In the offspring of women with ulcerative colitis, we found no increased risk of low birth weight or signs of intrauterine growth retardation. The risk of preterm birth was increased in the offspring of women with ulcerative colitis, particularly when the first hospitalization for ulcerative colitis occurred during pregnancy.

Adult↗