Grand multiparity associated with unilateral renal, ovarian, and Müllerian agenesis.
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[Fatty dystrophy of the liver in highly productive cows and multiparous sheep].
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Animals↗
Clinical and endocrinological aspects of induced parturition in multiparous sows.
Intramuscular administration of PGF2alpha or its analogue ICI 80996 at 110--112 days of gestation results in grouped parturition. The decrease of progesterone levels is interrupted by a temporary increase. During expulsion rather high values are obtained compared to the control group. Unconjugated oestrogens increase, reaching maximum values just before expulsion.
Animals↗
[The oligogene of multiparity in sheep].
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Animals↗
[Comparative characterization of iron metabolism in primiparous and multiparous women].
Comparative assessment of iron metabolism in the population of multiparas and grand multiparas indicates that the latter are at risk to develop iron-deficiency anemia. Ferrokinetic parameters in both populations evidence iron deficiency, especially in grand multiparas. As shown by ferritin assays in the serum, body iron in the grand multiparas is 15.5 times less than that in healthy nonpregnant women. In grand multiparas iron deficiency presented in light and moderate degrees.
Adult↗
[Assessment of the diagnostic value of fetal biophysical profile in multiparous women].
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Adult↗
[Uterine activity in primiparous and multiparous women in spontaneous labor and induced labor with oxytocin].
An analysis was performed of 5187 intra-amniotically measured labor pressure curves in 40 births with spontaneous labour (20 primiparae and 20 multiparae) and 40 births births in which labor was induced with oxytocin (20 primiparae and 20 multiparae). The dilatation of the os uteri was divided into three phases--Phase 1, dilatation of the cervix to 2 cm; Phase 2, dilatation of the cervix from 2 to 4 cm, and Phase 3, dilatation from 4 cm onwards until complete. During the active phase, from 2 cm until dilatation of the os uteri was complete, no differences were observed between induced and spontaneous labor with regard to frequency and amplitude of contractions. In the induced-labor cases, the parameters for uterine activity, maximum contraction and dilatation speed were higher in all three phases of labor, and those for total duration of labor lower than in the spontaneous labor cases. The contraction/dilatation speed is an important parameter for monitoring the effect of drug-induced stimulation of labor. In the latency phase in spontaneous labor, more contractions were observed in multiparae than in primiparae. This fact which should be reason enough to intensify monitoring of both mother and fetus during this phase. In light of these results it would appear advisable, in the absence of progress in labor, to make a clear distinction between the goals of cervical maturity and promotion of uterine activity, and to institute different drug therapy accordingly.
Adult↗
Energy metabolism during late gestation and lactation in multiparous sows in relation to backfat thickness and the interval from weaning to first oestrus.
Ten crossbred, fourth or fifth parity sows were divided into 2 groups - high (H) and low (L)- according to their backfat thickness 9 days before parturition. Body weight, backfat thickness and litter weight were recorded repeatedly during a 5 week lactation period. The length of the interval from weaning to first oestrus was also noted. All sows were fed a commercial diet (11.9 MJ/kg, 14.5% crude protein). During gestation, daily food intake was 2.2 kg/sow, while during lactation it was 3.0 kg/sow plus 0.4 kg/piglet. Blood samples were drawn on day 9 before parturition and on days 2, 7, 14 and 21 of lactation. The samples were analysed to determine concentrations of glucose, urea nitrogen, creatinine, triglycerides, free fatty acids and beta-hydroxybutyric acid. In both groups, concentrations of free fatty acids and urea nitrogen were low on day 9 before parturition while those of triglycerides were high, indicating anabolism regardless of backfat thickness. During the first week of lactation, concentrations of free fatty acids increased in the H-group but not in the L-group, and concentrations of urea nitrogen were higher in the H-group. These differences, together with the greater loss of weight observed in the H-group, indicate that catabolism of maternal fat and protein depots was more pronounced in the H-group than in the L-group during this time. On day 14 of lactation, both groups showed equally low concentrations of free fatty acids, decreasing creatinine concentrations and stable triglyceride and urea nitrogen concentrations. Furthermore, weight loss during the second and third weeks of lactation was low in both groups. These facts, taken together, indicate that the catabolic rate was decreasing in both groups during this period. No differences in return to oestrus interval were noted between the groups. The present study indicates that under a restricted feeding regime the catabolic rate during the first week of lactation is higher in sows with higher backfat thickness in late gestation. As lactation progresses, a more balanced metabolism is achieved regardless of backfat thickness, which may tend to reduce differences in return to oestrous interval.
Adipose Tissue↗
Prenatal weight gain, term birth weight, and fetal growth retardation among high-risk multiparous black and white women.
OBJECTIVE: To examine the association of prenatal weight gain below, within, and above the Institute of Medicine guidelines with birth weight and fetal growth restriction (FGR) among low-income, high-risk black and white women. METHODS: Eight hundred three black and 365 white women were grouped by pregravid body mass index (BMI): low (below 19.8), normal (19.8-26), high (above 26-29), and very high (above 29). The impact of maternal weight gain on birth weight and race-specific FGR was determined while controlling for sociodemographic and reproductive variables and for time between last weight observation and delivery. RESULTS: One-third of both black and white women failed to achieve the Institute of Medicine minimum recommended gain for pregravid BMI. More women with low BMI gained less than the recommended weight as compared with those having normal, high, or very high BMI. Nonobese black women (BMI 29 or below) delivered fewer infants with FGR as weight gain increased from below the recommended range (17.9% FGR) to within (10.3% FGR) or above (3.8% FGR) the range; corresponding data for nonobese white women were 20.9, 19.1, and 10.5% FGR, respectively. Obese black women (BMI above 29) also delivered fewer infants with FGR (4.2%) when they exceeded the minimum gain (6 kg) than did white women (11.8%). When analysis of covariance was used to adjust mean birth weight, black women in each pregravid BMI category delivered increasingly larger infants (P < or = .01 for each category) as they met or exceeded the guidelines; among white women this trend was attenuated. CONCLUSION: These observations support the Institute of Medicine suggestion that black women strive for prenatal weight gain at the upper end of the recommended range for pregravid BMI.
Adult↗
[Multiparity in Nicaragua].
The relation between birthweight and parity of the mother was examined in Nicaraguan patients from the capital Managua. 7431 births were taken into consideration from 1989-1991. 564 (= 7.6%) of these newborns were born to mothers with more than 5 deliveries. A positive correlation between the increasing number of the parity and the birthweight can be demonstrated in our patients until parity 10, however there are decreases in the birthweight of female newborns between parity 3 to 4 and 5 to 6 and in males between parity 6 to 7 and parity 8 to 9. The average age of a Nicaraguan primipara is 20.7 years and increases by 1.9-2.4 years until parity 5. From parity 6 to parity 15 it increases only by 0.7-1.2 years.
Adult↗
[Pregnancy and labor in 335 cases of high multiparity].
It had been accomplished an investigation upon the pregnancy and the birth of 335 women in labour with high (> or = 5) parity (grandmultimaras = GM), including 11 736 labour, taking place in the Clinic of Obstetrics of Pleven Medical University. Controllable group had been formed out of a 655 women in labour with a parity from 1 to 4. It had been used a questionnaire method. Higher in the main group was the frequency of a hypertension, placental pathology (pl. praevia, abruptio et retention placentae) and that of a transverse and oblique presentation of the foetus. Lower in GM was the frequency of the neonates with a very low birth weight < 1500 g (VLBW), the frequency of induction and stimulation of the labour act, and of episiotomy and ruptures of the perineum. We come to the conclusion about the low level of obstetric risk with GM when there was an accessible and a competent obstetric assistance.
Adult↗
The "dangerous multipara": fact or fiction?
OBJECTIVE: Our purpose was to compare the intrapartum complication incidence among grand multiparous women with that of age-matched control multiparous women. STUDY DESIGN: A total of 382 grand multiparous women (para > or = 5) were compared with 382 age-matched control subjects (para 2 to 4), all delivering between July 1989 and September 1991. Intrapartum complications classically associated with grand multiparity (abruptio placentae, dysfunctional labor, fetal malpresentation, postpartum hemorrhage, and shoulder dystocia) were compared. RESULT: Both groups had comparable antepartum complications and gestational ages at delivery. The overall intrapartum complication incidence for grand multiparous women was 33% (127/382 patients), not significantly different from that of the control multiparous women, 27% (103/382). Grand multiparity was associated with an increased incidence of macrosomia (16% vs 11%) and a decreased incidence of operative delivery (14% vs 21%). Macrosomia increased the incidence of intrapartum complications from 31% to 46% (p < 0.03) in the grand multiparous patients, and a trend was observed in the multiparous patients, from 26% to 37%. However, when properly controlled, this was noted to be a confounding variable and was not related to parity. CONCLUSIONS: In a largely Hispanic population grand multiparous patients do not have an increased incidence of intrapartum complications.
Adult↗
Hypertensive diseases of pregnancy and parity.
Chesley's classic long-term follow up study of eclamptic women clearly demonstrated the prognostic significance of parity in the differential diagnosis of various hypertensive diseases of pregnancy. Multiparous patients with eclampsia were different on long-term follow-up from primiparous eclamptic women. A logical conclusion from this observation is that multiparous and primiparous patient groups should be analyzed separately whenever hypertensive diseases of pregnancy are evaluated. This study is therefore an attempt to define the clinical profile of hypertension during pregnancy on the basis of parity alone. The prenatal and hospital records of 99 successive pregnant patients identified as hypertensive during a 1-year period at Mount Sinai Hospital Medical Center served as the study population. A group of 25 primiparous and 25 multiparous patients, all with uncomplicated pregnancies and normal deliveries in sequence during a 1-month period, served as normal nonhypertensive control groups. Various pregnancy parameters were statistically evaluated for study and control groups. Significant differences were found between hypertensive primiparous and multiparous patients in mean weight increase (p less than 0.05), gestational age at first increase in blood pressure (p less than 0.007), and time from first increase in blood pressure until delivery (p less than 0.008). The difference in birth weight was not significant between hypertensive groups. In contrast, among the control groups, multiparous patients had significantly larger offspring than primiparous patients (p less than 0.01). Weights of normal primiparous control women were almost identical to those of primiparous hypertensive women (3252.8 +/- 511.8 versus 3203.26 +/- 679.5 gm). Birth weights of offspring from multiparous hypertensive women, while not significantly different from those of primiparous hypertensive women, were significantly lower than those of multiparous control subjects (3093.94 +/- 898.7 versus 3593 +/- 305.6; p less than 0.01). No significant differences in a variety of laboratory findings, reflexes, edema, or mode of delivery were observed between the various groups. The clinical and laboratory presentation of hypertension in pregnancy may be similar between primiparous and multiparous patients. Nevertheless, clear differences do exist in both maternal presentation and impact of maternal disease on fetal growth and development. These differences strongly suggest a different pathophysiology as the underlying cause of hypertensive disease in primiparous and multiparous pregnant women.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Effects of feeding two levels of propionibacteria to dairy cows on plasma hormones and metabolites.
To determine the effect of feeding propionibacteria on metabolic indicators during lactation, multiparous and primiparous Holstein cows were fed one of three dietary treatments in a 2 x 3 factorial design from 2 weeks prepartum to 30 weeks post partum: (1) Control (primiparous n=5, multiparous n=8) fed a total mixed ration (TMR); (2) high-dose group (primiparous n=6, multiparous n=5) fed TMR plus 6 x 10 (11) cfu/head daily (high-dose P169) of propionibacterium strain P169; or (3) low-dose group (primiparous n=8, multiparous n=6) fed TMR plus 6 x 10(10) cfu/head daily (low-dose P169) of P169. Blood samples were collected weekly and analysed for plasma concentrations of glucose, insulin, insulin-like growth factor-I (IGF-I), leptin, nonesterified fatty acids (NEFA) and cholesterol. Between weeks 25 and 30, all groups received bovine somatotropin (bST) every 2 weeks. Low-dose P169 multiparous cows had lower (P<0.05) plasma insulin and glucose concentrations than high-dose P169 multiparous cows, whereas high-dose P169 primiparous cows had lower glucose but greater insulin concentartions than low-dose P169 primiparous cows (P<0.05). Plasma insulinratioglucose molar ratios were 13-18% lower (P<0.05) in low-dose P169 cows than in control or high-dose P169 cows. Plasma IGF-I, NEFA and leptin levels did not differ among diet groups between weeks 1 and 25. Low-dose P169 multiparous cows had 25% greater plasma cholesterol levels than high-dose P169 and control multiparous cows, but cholesterol levels in primiparous cows did not differ. During bST treatment, high-dose P169 multiparous cows and low-dose P169 primiparous cows had lower IGF-I levels than their respective controls and, regardless of parity, high-dose P169 cows had greater NEFA than control cows. Although supplemental feeding of P169 altered plasma hormones and metabolites, the particular effects were dependent on dose of P169 and parity of cows.
Animal Feed↗
The labor curve of the grand multipara: does progress of labor continue to improve with additional childbearing?
OBJECTIVE: Our purpose was to test the hypothesis that progress of labor slows as parity exceeds 4 by comparing labor curves of grand multiparous women (para 5 and over) (GMs) with those of nulliparous and lower-parity multiparous women. STUDY DESIGN: Retrospective cohorts of spontaneously laboring, vertex-presenting, term GMs who were admitted to two medical centers during the period from January 1990 through June 1995 were randomly computer-matched to a nulliparous and a lower-parity multiparous control subject, matched for age, hospital, and year of delivery. Cervical examination data were graphed retrospectively from the time of full dilatation. Curves were compared by pairwise likelihood ratio tests, by using a random effects model to adjust for obstetric interventions, with significance set at P <.05. RESULTS: Pregnancies in 1095 GMs, 1174 lower-parity multiparous women, and 908 nulliparous women were studied. GMs exhibit a longer initial phase of labor than either nulliparous women or lower-parity multiparous women, begin to dilate rapidly at a greater dilatation than nulliparous women, and experience acceleration of labor at a rate no faster than lower-parity multiparous women. The average labor curve of GMs resembles that of nulliparous women before dilatation of 4 cm is attained, then transitions to the typical curve of the lower-parity multiparous women until dilatation of 6 cm is attained and thereafter is indistinguishable from that of the lower-parity multiparous women (P <.001). CONCLUSIONS: Once parity exceeds 4, progress of labor slows. "Poor progress" beyond dilatation of 4 cm should not be considered abnormal for a GM, because she is likely still in the latent phase until dilatation of 6 cm is attained. Nor should she be expected to progress through her active phase any faster than lower-parity multiparous women.
Adult↗
Endocrine changes before and after weaning in response to boar exposure and altered suckling in sows.
Eighteen sows (6 primiparous and 12 multiparous) were allotted randomly within parity to two lactational treatments: litter separation (LS; 6 h/day) plus boar exposure (BE; 1 h/day; N = 14) beginning 8 days before weaning (4 weeks) and no LS + no BE (controls; N = 4). Blood was collected from all sows via indwelling venous catheters at 20-min intervals for 5 h on Days -1, 0, 1, 2 and 3 from start of treatment. Control sows and those exposed to LS + BE not exhibiting oestrus during lactation were resampled on Days -1, 0, 1 and 2 from weaning. All 10 multiparous sows receiving LS + BE exhibited oestrus during lactation, whereas none of the 4 primiparous sows exposed to LS + BE or the 2 control multiparous and 2 control primiparous sows exhibited lactational oestrus. Overall concentrations of LH in serum were higher (P less than 0.05) in sows receiving LS + BE than in control sows during lactation, whereas overall FSH was higher (P less than 0.05) in primiparous than multiparous sows. Number and amplitude of pulses of LH were greater (P less than 0.05) for treated primiparous than multiparous sows during lactation. Oestradiol-17 beta increased (P less than 0.05) in sows during LS + BE and was higher (P less than 0.01) in multiparous sows of this group than control multiparous or treated primiparous sows. Preweaning concentrations of cortisol and progesterone in serum were higher (P less than 0.05) in treated than control sows for multiparous and primiparous animals. In sows resampled at weaning, the number of pulses of LH was greater (P less than 0.05) in treated primiparous than in control sows. Postweaning concentrations of FSH in serum were unaffected by preweaning treatments. It was concluded that (1) litter separation and boar exposure increased basal and pulsatile secretion of LH in multiparous and primiparous sows; (2) lack of ovarian follicular development and oestradiol secretion may preclude expression of oestrus in primiparous sows during lactation, despite elevated concentrations of FSH and LH in serum; and (3) if elevated concentrations of cortisol and progesterone inhibit the onset of oestrous cycles, in response to litter separation and boar exposure during lactation, the effect is limited to primiparous sows.
Animals↗
Pregnancy outcome at age 40 and older.
OBJECTIVE: Our purpose was to examine pregnancy outcomes among women age 40 or older. METHODS: Between January, 1997 and December 1999, we performed a case-control study compared pregnancy outcomes of 468 patients delivered at our hospital at > Or = 40 years old with outcomes in a control group consisting of the next two deliveries of women with ages 20 to 29 years. Retrospective analysis of the antepartum and intrapartum records was done to compare clinical outcome. RESULTS: Approximately 25,356 women delivered during the study period, and 468 (1.8%). Of these women were at age 40 or older. Of this latter group, 50 (10.7%) were nulliparous. Mean birthweight of infants delivered by older nulliparous women was significantly lower than that among nulliparous controls (3,210 +/- 5 vs. 3,320 +/- 1 g), whereas mean birth weight in the group of older multiparous was not different than that among younger multiparous controls (3,370 +/- 1 vs. 3,365 +/- 4 g). Gestational age at delivery was significantly lower among older nulliparous, and multiparous compared with nulliparous and multiparous younger controls. Older women were at increased risk for cesarean delivery (nulliparous 18%; multiparous 14%) compared with nulliparous and multiparous younger control groups (nulliparous 8%; multiparous 6%). In the study group, the operative vaginal delivery rate was higher than that of the control group. The study groups were more likely to develop gestational diabetes, preeclampsia, and placenta praevia. Older nulliparous had an increased incidence of malpresentation, abnormal labour patterns, special care baby unit admission (SCBU), and low 1-minute Apgar score. Older multiparous were more likely to experience birth asphyxia, premature rupture of membranes, and antepartum vaginal bleeding. CONCLUSION: Nulliparous women age 40 or over have a higher risk of operative delivery than do younger nulliparous women. This increase occurs in spite of lower birth weight and gestational age and may be explained by the increase incidence of obstetric complications. Although maternal morbidity was increased in the older women, the overall neonatal outcome did not appear to be affected.
Adult↗
Effect of folic acid and glycine supplementation on embryo development and folate metabolism during early pregnancy in pigs.
The present work aimed to determine if different levels of prolificacy either by parity or by genetic origin are linked to folate metabolism. Nulliparous Yorkshire-Landrace (YL) and multiparous YL, and multiparous Meishan-Landrace (ML) sows were randomly assigned to two treatments: 0 ppm or 15 ppm folic acid+0.6% glycine. Supplements were given from the estrus before mating until slaughter on d 25 of gestation. At slaughter, embryo and endometrial tissues were collected to determine concentrations of DNA, protein, and homocysteine. Allantoic fluid samples were also collected to determine concentrations of folates, vitamin B12 and amino acids. Blood samples were taken at first estrus, at mating, and on d 8, 16, and 25 of gestation to determine serum concentrations of folates, vitamin B12, and relative total folate binding capacity (TFBC). Over the entire experiment, multiparous YL sows had higher average serum concentrations of folates than nulliparous YL sows (P < 0.05) but had similar serum concentrations of relative TFBC. Concentrations of folates and relative TFBC averaged higher in ML measured over the entire experiment than in multiparous YL sows (P < 0.05). Concentrations of serum vitamin B12 were higher in multiparous YL than in ML sows or YL nulliparous sows (P < 0.05) over the entire experiment. In allantoic fluid, folates, vitamin B12, and essential amino acids contents were significantly lower in ML than in YL multiparous sows (P < 0.05). The folic acid+glycine supplement increased concentrations of serum folates, but the increase was more marked in nulliparous YL sows (nulliparous x folic acid+glycine, P < 0.05). The folic acid+glycine supplement had no effect on litter size and embryo survival, but it tended to increase embryo DNA in multiparous YL sows (P = 0.06) but not in ML and nulliparous YL sows. Homocysteine was decreased by folic acid+glycine supplement in embryos from all sows, but in endometrium, the folic acid+glycine effect was dependent on parity (nulliparous x folic acid+glycine, P < 0.05). The effects of folic acid+glycine on litter size and embryo development and survival and some aspects of folate metabolism suggest that the basal dietary content of folic acid+glycine was adequate for ML and nulliparous YL sows but not to optimize embryo development in YL multiparous sows.
Allantois↗