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PubMed2006

Risk factors for udder edema and its association with lactation performance on primiparous Holstein cows in a large Florida herd, U.S.A.

The objective of this study was to determine risk factors for udder edema (case-control study) and to evaluate the association of udder edema in primiparous Holstein cows with their lactation performance (cohort study). Values for the first 10 test day for milk yield, fat, protein, and somatic cell counts (SCC) linear score as well as mature equivalent (ME) 305 days milk yield, fat, protein, SCC linear score, and incidences of periparturient diseases from a computerized farm recording system were compared between primiparous cows with and without udder edema. Data consisted of 118 dairy heifers with udder edema, induced for parturition, and treated with diuretics and 889 control heifers that received no treatment. Primiparous cows giving birth to male calves, were 1.72 (1.01, 3.24; 95% CI) times more likely to develop udder edema than cows giving birth to female calves. Primiparous cows calving in winter season were 3.68 (1.09, 12.5; 95% CI) times more likely to develop udder edema than cows calving in summer. For each extra 10cm in height the odds of udder edemas was 1.23 (1.03, 1.47; 95% CI). The first test day DHIA milk yield was lower in cows that developed udder edema (3.6kg/day) than in normal cows. However, the subsequent test days and ME measurements were not statistically different between groups. Cows with udder edema were 1.62 (1.18, 2.14; 95% CI) times more likely to develop udder edema in the second lactation than control animals. It is concluded that the gender of the offspring, calving season and height at parturition were significant risk factors for udder edema. Only milk yield on the first DHIA test day was lower in cows with udder edema than in cows without udder edema.

Animals↗
PubMed2005

[Obstetrical risk factors of 365 primiparous adolescent pregnancies in Reunion Island].

OBJECTIVES: Analysis of obstetrical risk factors in teenage primiparous pregnancies in Reunion Island (4% of total births). MATERIALS AND METHODS: Retrospective study, between 2001 and 2002, comparing primiparous adolescents (13-17 years, n = 365), with primiparous controls (18-29 years, n = 2050). The analysis included demographical factors, maternal medical histories, prenatal follow-up, obstetrical risk factors, delivery modes and neonatal characteristics. RESULTS: Adolescents attended on average 8 prenatal consultations, however 4% had poor prenatal care (less than 3 visits, OR 4.2, P < 0.001 vs controls). They presented less gestational diabetes, but there were no differences concerning pre-existing hypertension, hypertensive disorders of pregnancy, medical reasons of hospitalisation between the two groups. Mode of delivery was more favorable in adolescents (half rate of caesarean sections, shorter duration of membrane ruptures). Nevertheless, adolescents presented a higher risk of severe prematurity (<32 Weeks gestation, incidence 3.6% vs 1.6%, OR 2.3, p = 0.008). CONCLUSION: With optimal prenatal care (more than 90% of our cohort), primiparous adolescents present globally a favorable course of their pregnancies and have better deliveries than their young (18-29 years) counterparts. However, there is a significant risk of severe prematurity requiring special care for these pregnancies.

Adolescent↗
PubMed2003

Timing of ovulation and conception rate in primiparous and multiparous cows after synchronization of ovulation with GnRH and PGF2alpha.

Conception rates after Ovsynch have been higher in primiparous than in multiparous cows. The objective of this study was to investigate whether this difference might be due to differences in ovulation rate or follicular size. The experiment was conducted with 136 Holstein Frisian cows from a commercial herd in Brandenburg, Germany. All cows were synchronized using Buserelin (GnRH analogue) at day -10, Tiaprost (PGF2alpha analogue) at day -3 and again GnRH at day -1. Timed artificial insemination (TAI) was carried out 16-20 h after the second dose of GnRH on day 0. Milk samples for analysis of milk progesterone were obtained on days -17, -10, -3 and at TAI. Progesterone concentrations were used to determine the stage of oestrus cycle at the start of the synchronization protocol and to investigate the presence of functional luteal tissue before treatment with PGF2alpha and TAI. All animals were examined by ultrasound at the second treatment with GnRH, at AI, 8 and 24 h after AI. Overall synchronization rate (proportion of cows with an ovulation within 40 h after GnRH) was 86.8% in primiparous and 88.2% in multiparous cows, respectively. Ovulation occurred earlier in primparous than in multiparous cows (p < 0.05) and ovulatory follicles were smaller. Conception rates were numerically higher in primiparous cows but the difference was not significant. Cows that displayed signs of oestrus on day -1 and received an additional AI on this day were more likely to conceive than cows that only received TAI 16 to 20 h after GnRH2. It is concluded that ovulation occurs earlier in primiparous than in multiparous cows after Ovsynch. However, a significant relationship between these differences and the probability of conception could not be established.

Animals↗
PubMed1996

Screening primiparous women and newborns for fetal/neonatal alloimmune thrombocytopenia: a prospective comparison of effectiveness and costs. Immune Thrombocytopenia Working Group.

A prospective study was conducted in three maternity wards to compare the medical outcomes and the costs of two screening strategies for the detection of fetal/neonatal alloimmune thrombocytopenia (FMAIT). A total of 2066 primiparas and 6081 newborns were included. Fifty-two primiparous women with HPA-1b phenotype were found, and 45 were followed during pregnancy. Four women developed antibodies, and two fetuses exhibited FMAIT; therefore, the prevalence of anti-HPA-1a was 2 per 1000, and the prevalence of FMAIT 1 per 1000. Forty-eight thrombocytopenic newborns were found out of a total of 5632 blood samples. Five were HPA-1a children whose mothers were HPA-1b. The cost-effectiveness of screening all primiparous women was $45,000 and of screening all newborns is $18,000-per anti-HPA-1a alloimmunization diagnosed. Costs per fetal death or disability averted were $500,000 for the primiparous strategy and $225,000 for the newborn strategy. In conclusion, screening newborns for neonatal alloimmune thrombocytopenia is more cost-effective than screening primiparous women.

Antigens, Human Platelet↗
PubMed1998

Influence of early post partum ovulation on the re-establishment of pregnancy in multiparous and primiparous dairy cattle.

To investigate the influence of early ovulation after calving on subsequent fertility, milk progesterone concentrations were monitored twice weekly in multiparous (n = 87) and primiparous (n = 60) Holstein/Friesian dairy cattle. Luteal activity before 21 days post partum was defined as 'early'. In multiparous cows, calving-to-conception interval (CCI) was longer, services per cow were more numerous and conception rate to all inseminations was lower with early luteal activity (n = 41, 16.8 +/- 0.39 days post partum) than with later luteal activity (n = 46, 37.8 +/- 2.09 days post partum); multiparous cows with early luteal activity required more exogenous fertility treatments and were more likely to fail to conceive by 100 days post partum. In contrast, in primiparous cows, no significant relationships were detected between early (n = 32) or later (n = 28) luteal activity and the CCI, number of services per cow or conception rates to all inseminations. However, primiparous cows that ovulated before 21 days post partum had fewer normal progesterone profiles. Early ovulation after calving was associated with reduced pregnancy rates and prolonged CCIs in multiparous but not in primiparous dairy cows.

Animals↗
PubMed2000

Attack rates of human papillomavirus type 16 and cervical neoplasia in primiparous women and field trial designs for HPV16 vaccination.

BACKGROUND: Identification of human papillomavirus type 16 (HPV16) as the major risk factor for cervical neoplasia, and mass production of DNA free HPV capsids have paved the way to preventive vaccination trials. Design of such trials requires reliable attack rate data. OBJECTIVE: Determination of (1) HPV16 and (2) cervical neoplasia attack rates in primiparous women. Estimation of actuarial sample sizes for HPV16 vaccination phase IV trials. DESIGN: A longitudinal cohort study. METHODS: Population based Finnish Maternity Cohort (FMC) and Finnish Cancer Registry (FCR) were linked for the identification of two cohorts of primiparous women: (1) a random subsample of the FMC: 1656 women with two pregnancies between 1983-9 or 1990-6 and living in the Helsinki metropolitan area, and (2) all 72,791 primiparous women living in the same area during 1983-94. Attack rate for persistent HPV16 infection (1) was estimated in 1279 seronegative women by proportion of seroconversions between the first and the second pregnancy. Comparable 10 year cumulative incidence rate (CR) of cervical intraepithelial neoplasia grade III and cervical cancer (CIN III+) (2) was estimated based on cases registered at the FCR during 1991-4. RESULTS: The HPV16 attack rates were 13.8% (< 18 years), 7.0% (18-19 years), 2.3% (21 years), 2.4% (23 years), and 4.5% (< 25 years). Number of vaccinees required for a 5 year efficacy trial with persistent HPV16 infection as the end point ranged between 1000 and 3900, assuming 80% power, 90%-70% vaccine efficacy (VE), and misclassification. The CRs of CIN III+ were 0.33% (< 18 years), 0.44% (18-19 years), 0.21% (20-24 years), and 0.28% (< 25 years). Number of vaccinees required for a 10 year efficacy trial with HPV16 positive CIN III+ as the end point was 15,000 assuming 80% power, 90% VE, and 75% aetiological fraction of CIN III+ for HPV16. CONCLUSIONS: The attack rates of HPV16 and CIN III+ identify primiparous women under 25 years of age among target populations for postnatal HPV vaccination at phase II/III trials.

Adolescent↗
PubMed2006

Metabolic profiles in ovulatory and anovulatory primiparous dairy cows during the first follicular wave postpartum.

Metabolic hormones affect ovarian function in the cow. However, the relationship between metabolic factors and ovarian function is not clear in the postpartum primiparous cow because they are still growing. The aim of the present study was to investigate in detail the time-dependent profile of the metabolic hormones, metabolites, and milk yields of ovulatory and anovulatory primiparous cows during the first follicular wave postpartum. We used 16 primiparous Holstein cows and obtained blood samples for the profiles of metabolites (glucose; non-esterified fatty acid, NEFA; ketone body; total cholesterol; and aspartate aminotransferase), metabolic hormones (growth hormone, GH; insulin-like growth factor-I, IGF-1; and insulin), and progesterone every other day from 1 to 21 days postpartum. In addition, all ovaries were observed using ultrasound. Dairy milk yield was recorded during the experimental period. In all cows, the first follicular wave postpartum was observed and 6 of the cows ovulated. The plasma glucose (P<0.0001) and IGF-1 (P<0.001) concentrations were lower and the plasma NEFA (P<0.0001) and ketone bodies (P<0.0001) concentrations and daily milk yield (P<0.0001) were higher in the anovulatory cows compared to the ovulatory cows. However, the GH levels, which enhance lipolysis for milk production, insulin and other metabolites did not differ between the two groups. In conclusion, the present study suggests that anovulation of the dominant follicle during the first follicular wave postpartum in primiparous cows is induced by low IGF-1 levels that are similar to those of multiparous cows. In addition, anovulatory cows are likely to mobilize body fat stores for milk production more easily than ovulatory cows.

Animals↗
PubMed1994

Cesarean section and operative vaginal delivery in low-risk primiparous women, Western Australia.

OBJECTIVES: A major component of the increasing trend in cesarean sections in Western Australia is the rise in emergency cesarean sections in primiparous women. The aim of this study was to identify independent risk factors (particularly those known early in pregnancy) associated with operative delivery in low-risk primiparous women. METHODS: Retrospective multivariate logistic regression analyses of antenatal and perinatal data were conducted for all low-risk primiparous women entering labor spontaneously and giving birth in Western Australia in 1987 (n = 3641). RESULTS: Of the subjects, 58% had a spontaneous vaginal delivery, 8% had an emergency cesarean section, and 34% had an operative vaginal delivery. The significant independent risk factors for emergency cesarean section were older maternal age, shorter maternal height, heavier infant birthweight, and long labor. The risk factors for operative vaginal delivery were older maternal age, shorter maternal height, heavier infant birthweight, epidural anesthesia, labor/delivery complications, male infant, private patient status, and being married. CONCLUSIONS: This multivariate analysis confirms known risk factors for operative delivery in low-risk primiparous women and suggests that it may be possible to predict the likelihood of operative delivery for an individual woman by using knowledge of maternal age and height and assessment of infant birthweight.

Adult↗
PubMed1986

Effect of lactation and rebreeding phase energy intake on primiparous and multiparous sow performance.

Fifty-three primiparous sows were used to study the effects of a high-energy, fat-supplemented diet on sow lactation and rebreeding performance. Sows received either a low [Lo, 12.5 Mcal metabolizable energy (ME)/d] or high (Hi, 16.0 Mcal ME/d) energy sorghum-soybean diet during a 28-d lactation. At weaning, sows were randomly allotted, within lactation treatment, to a low (lo, 5.54 Mcal ME/d) or high (hi, 9.61 Mcal ME/d) energy sorghum-soybean diet until the day of first postweaning estrus. Primiparous sows fed Lo weaned larger (P less than .05) litters than sows fed Hi; however, average pig weight was not affected by lactation treatments. Primiparous sows fed Hi had more backfat at weaning (P less than .01) than Lo sows. In contrast, sow weight was not affected by dietary treatments. Neither lactation nor rebreeding treatments influenced days to rebreeding; however, an interaction (P less than .01) was observed. Mean days from weaning to rebreeding for Lolo, Lohi, Hilo and Hihi sows were 10.0, 7.6, 6.9 and 17.1, respectively. Forty sows were maintained on the same dietary treatments during their second parity. Sows receiving Lo during their second parity farrowed and weaned more (P less than .05) pigs than Hi sows. Multiparous sows fed Hi nursed heavier (P less than .05) pigs on d 21 of lactation and at weaning compared with Lo sows. Sows fed Hi were heavier (P less than .05) and had more (P less than .01) backfat at weaning of their second litter compared to Lo sows. Days to postweaning estrus were not affected by lactation or rebreeding diets. Mean length of the second parity rebreeding interval for Lolo, Lohi, Hilo and Hihi sows was 6.2, 10.2, 7.0 and 10.5 d, respectively. These results suggest that feeding levels during lactation of 12.5 Mcal ME/d or higher supported adequate rebreeding performance. Postweaning feeding levels did not influence days to first estrus. Feeding a high energy diet continuously throughout the lactation and rebreeding phases in primiparous sows may lengthen the postweaning interval to estrus.

Animals↗
PubMed2004

Moderate inflammatory reaction during experimental Escherichia coli mastitis in primiparous cows.

Nineteen primiparous cows were experimentally infected in 2 quarters with 1 x 10(4) (group A) or 1 x 10(6) (group B) cfu of Escherichia coli P4:O32 per quarter within 2 to 4 wk after parturition. Blood and milk samples were collected from all primiparous cows at regular time intervals from d -4 to d +3 relative to inoculation. Milk production rapidly decreased in both groups during E. coli mastitis, but recovery appeared to be faster in group B at d + 1 postinfusion (p.i.). The milk production losses in the noninfected quarters were substantial on the day of inoculation, which is probably due to pronounced systemic effects. However, on d + 2 p.i. milk production in the noninfected quarters nearly reached preinfection levels, indicating a moderate clinical severity following intramammary inoculation. None of the other severity criteria evolved towards a severe response pattern. Reticulorumen motility was inhibited in both groups during E. coli mastitis. The clinical episode was short lasting in both groups. Rectal temperature, heart rate, blood leukocyte count, number of colony-forming units, milk somatic cell count and several indicators for the disintegration of the blood-milk barrier returned to normal values within 24 to 72 h p.i. Primiparous cows reacted with a moderate inflammatory response following intramammary infusion with a relatively high dose of E. coli. Despite the use of a high inoculum dose, primiparous cows in both groups showed pronounced resistance against severe intramammary E. coli infection. A possible effect of the inoculum dose could be present, however, further research into the effect of the inoculum dose on the inflammatory response should be performed.

Animals↗
PubMed2001

Loss of calcineurin from the medial preoptic area of primiparous rats.

Western blot analyses reveal that calcineurin A (CNA), which is present in the hippocampus, basolateral amygdala, parietal cortex, and MPOA of virgin males and females, is undetectable only in the MPOA of primiparous females regardless of whether they had postpartum pup contact or not. In contrast, CNB was expressed at unchanging levels in the PC and MPOA. Similarly, G(alphao) and PKA(RI) were expressed at high levels in all of the brain regions of virgin males, virgin females, and primiparous females, supporting the concept that this loss of CNA is a specific event. Understanding how and why the expression of CNA, the sole neuronal Ca2+/CaM-dependent protein phosphatase, is down-regulated specifically in the MPOA of primiparous females may yield some insight into the signal transduction events that mediate the onset of mammalian maternal behavior.

Amygdala↗
PubMed2001

Anal sphincter injury after vaginal delivery in primiparous females.

PURPOSE: The purpose of this study was to determine the incidence of anal sphincter injury and fecal incontinence after vaginal delivery. METHODS: This was a prospective, descriptive, observational study conducted over a three-year period in healthy primiparous females with previously intact anal sphincter and normal continence and without history of anorectal surgery. All patients completed a continence questionnaire and underwent endoanal ultrasound four to six weeks before and six weeks after delivery. RESULTS: Ninety-eight primiparous females had either instrumental (vacuum or forceps) vaginal delivery (n = 23) or noninstrumental vaginal delivery (n = 75). Twenty patients, 11 (48 percent) after instrumental delivery and 9 (12 percent) after noninstrumental vaginal delivery, had clinical sphincter tears that required primary repair. Twenty-eight patients (29 percent), 19 with previously repaired sphincter injury, had ultrasonographic defects that involved the external sphincter (n = 19) or both the internal and external sphincter (n = 9). Twenty-one patients (75 percent) with ultrasonographic sphincter defects had either major (n = 5) or minor (n = 16) fecal incontinence. CONCLUSION: Anal sphincter injuries, many of them undiagnosed at the time of delivery, are common in primiparous females after vaginal delivery, especially if vacuum or forceps are used. These injuries cause fecal incontinence in a significant proportion of the patients. Patients undergoing vaginal delivery should be aware of the risks of anal sphincter injury.

Adolescent↗
PubMed2000

Postdelivery anal function in primiparous females: ultrasound and manometric study.

PURPOSE: A study was performed to evaluate the early morphologic and functional consequences of vaginal delivery on the anal sphincter in primiparous females. METHODS: Among a cohort of 197 primiparous females who agreed to participate in a clinical evaluation of fecal incontinence and in a transanal ultrasound examination 12 weeks after delivery, 52 also underwent anal manometry using a radial six-port catheter, of whom 10 were asymptomatic and had a normal sphincter at ultrasound and the remaining 42 had clinical signs of anal incontinence or ultrasonographic defects of the anal sphincter or both. Anal sphincter pressures and asymmetry index were analyzed at rest and during voluntary squeeze. Manometric and ultrasound results were compared, together with clinical symptoms. RESULTS: Fourteen patients with clinical signs of anal incontinence had lower resting and squeeze anal pressures than continent patients (P < 0.05), but similar anal asymmetry indexes. Patients with incontinence and an anal defect had the lowest resting and squeeze anal pressures (P < 0.05). Forceps assistance to delivery was not associated with a higher frequency of anal sphincter lesions. Resting and squeeze anal pressures were lower in the forceps group (P < 0.005), but anal asymmetry indexes were similar. Finally, manometric results were identical in the presence or absence of anal sphincter endosonographic defects. CONCLUSIONS: Anal sphincter defects are frequent after the first vaginal delivery, but are not always associated with functional or clinical abnormalities. Resting and squeeze anal pressures were significantly decreased in patients with incontinence and an anal defect and after forceps-assisted deliveries. Anal asymmetry index was not found useful in this population of young primiparous females.

Adult↗
PubMed2007

Factors associated with anal sphincter laceration in 40,923 primiparous women.

The objective of this study was to identify factors associated with anal sphincter laceration in primiparous women. A subpopulation of 40,923 primiparous women at term with complete data sets was abstracted from a state-wide perinatal database in Germany. Outcome variable was anal sphincter laceration. Independent variables were 17 known obstetrical risk factors/conditions/interventions impacting childbirth recorded on the perinatal data collection sheet. Cross table analysis followed by logistic regression analysis was used for data analysis. Logistic regression showed episiotomy (OR, 3.23; CI, 2.73-3.80) and forceps delivery (OR, 2.68, CI, 2.17-3.33) to be most strongly associated with anal sphincter laceration. Women with a BMI >or= 30 kg/m2, and smokers had a significantly lower risk of anal sphincter laceration. Local, pudendal, and epidural analgesia all reduced the risk of anal sphincter laceration. Iatrogenic factors most strongly associated with anal sphincter laceration in primiparous women include routine episiotomy and forceps delivery.

Adult↗
PubMed2005

Pre-eclampsia: is it a different disease in primiparous and multiparous women?

The aim of this study was to evaluate differences in clinical and laboratory parameters and differences in the complication rates between pre-eclamptic primiparous and pre-eclamptic multiparous women. A prospective case series of 112 primiparous and 186 multiparous women with pre-eclampsia was conducted at Princess Badea Teaching Hospital; a large tertiary public health service hospital in Irbid, North Jordan. A uniform medical and surgical management protocol was implemented. The main outcome measures included antenatal, intrapartum and puerperal, maternal and foetal complications. Multiple maternal and foetal demographic, clinical and laboratory parameters were studied. As expected, the primiparous were younger than the multiparous women. After adjusting for maternal age, regression analysis revealed no difference in the systolic or diastolic blood pressure in the two groups. It was also demonstrated that there was no statistically significant difference in the clinical presentation, haematological and biochemical parameters or ultimate maternal outcome between the two groups. After adjusting for babies' sex and gestational age, it was demonstrated that there was no statistically significant difference in the following: gestational age at delivery, foetal weight, stillbirth, admission rate to neonatal intensive care unit, neonatal death rate within the first four weeks after birth and incidence of intrauterine growth restriction between the two groups.

Adult↗
PubMed1994

The association of primiparity with intrauterine growth retardation.

The role of parity in the epidemiology of intrauterine growth retardation (IUGR) is not well understood, as some risk factors for IUGR are associated with young age and primiparity, and some are more frequent among older multiparous women. This paper examines the unique role of primiparity in the etiology of IUGR in a series of 25,614 singleton births in the southern part of Israel. The rates of IUGR were 3.5% among primiparae and 1.7% in multiparae. (Risk ratio = 1.99; 95% confidence interval, 1.69-2.35). Maternal age was associated with IUGR only among primiparae but not in multiparae. Of the obstetric factors examined, the following were found to be significantly associated with IUGR: hypertension, prior infertility, oligohydramnios, gross fetal congenital anomalies, and being a female fetus. After simultaneous adjustment for these risk factors by multiple logistic regression analysis, the odds ratio associated with parity was 1.62 (95% confidence interval, 1.30-2.01), suggesting that primiparity constitutes an independent risk factor for IUGR.

Adult↗
PubMed1976

Olfactory bulbectomy: influences on maternal behavior in primiparous and multiparous rats.

Bilateral olfactory bulb ablation resulted in deficits in several components of maternal behavior in lactating, primiparous female rats. These females frequently cannibalized pups shortly after parturition. Furthermore, bilaterally bulbectomized, primiparous females spent less time nursing their pups and retrieved fewer pups than unilaterally bulbectomized or sham-operated females. In contrast to the situation in primiparous females, in multiparous females bilateral bulbectomy failed to influence any parameter of maternal behavior.

Age Factors↗
PubMed1998

Comparative effects of early weaning or once-daily suckling on occurrence of postpartum estrus in primiparous beef cows.

We concurrently evaluated early weaning and once-daily suckling as options for shortening postpartum interval to estrus in primiparous cows calving in good body condition. Over 2 consecutive years, a total of 77 primiparous cows were assigned to 1 of 3 treatments: control (ad libitum suckling); once-daily suckling (for 30 d prior to start of breeding); or early weaning (calves weaned 30 d prior to start of breeding). All cows had a body condition score (BCS) of > or = 5 at parturition and were maintained in good condition throughout the breeding season. Cows were observed for estrus twice daily and blood samples for subsequent measurement of progesterone were collected at 48-h intervals. For data analysis, cows were divided into early- (> or = 85 d post partum) and late-calving (< 85 d post partum) groups at the onset of the breeding season. All calves were weighed at birth, at the onset of treatment, at weekly intervals until the start of the breeding season, and within 45 d of 205 d of age. Early weaning or once-daily suckling shortened the postpartum interval to first estrus of late-calving primiparous cows by 17 (P < 0.01) and 12 d (P < 0.08), respectively, compared with control group cows. However, among early-calving cows, neither early weaning nor once-daily suckling influenced the postpartum interval. Postpartum intervals of once-daily suckled cows and early-weaned cows were similar (P > 0.10).

Animals↗