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PubMed1982

Adult physiological response to infant cries: effects of temperament of infant, parental status, and gender.

This article describes research on adult physiological and self-report response to audiotapes of infants' cries. 3 groups were studied: nonparents, primiparous parents, and multiparous parents. The tapes consisted of cries ordered (difficult, average, easy) according to sound spectrographic features and infant temperament ratings. While nonparents and multiparous parents showed the expected order in arousal levels (difficult infant cries highest, easy infant cries lowest), primiparous parents had highest levels to average infant cries. Overall, primiparous parents had highest levels of arousal, nonparents next, and multiparous parents least. There were no gender differences in arousal. Difficult infant cries received higher irritation and spoiled ratings; were rated as more grating, arousing, piercing, etc.; were less similar to own infants' cries; and were said to be caused more frequently by frustration, etc., rather than routine physical discomfort. Fathers had higher irritation and spoiled ratings, and lower care for ratings, than mothers. The relationship of these data to own infant temperament ratings was also assessed.

Adult↗
PubMed1978

[Dynamics of the dilatation of as uteri during birth].

219 partogramms of primipares and 219 partogramms of multipares were analysed retrospectively. Only normal deliveries after normal pregnancies were taken into consideration. Graphs were plotted of time intervalls against the width of the cervix. The mean duration of dilation were 6 hours for multipares and 9 hours for primipares. All phases of first stage of labour were reduced in multipares. The results were compared with observations of other authors.

Cervix Uteri↗
PubMed1981

Immunological features of preeclampsia: increased frequency of antilymphocyte antibodies, but not of immune complexes.

Using two methods for detecting circulating immune complexes (CIC)--inhibition of antibody-dependent cell-mediated cytotoxicity and solid-phase C1q assay--we were unable to demonstrate CIC in sera from preeclamptic patients and from healthy pregnant women. Antilymphocyte antibodies were found much more frequently in multiparous women suffering from preeclampsia-like disease than in healthy multiparous pregnant control patients. They were not detected in primigravida uncomplicated or preeclamptic pregnancies. It is suggested, therefore, that preeclampsia may have a different etiology in the multiparous woman than in the primigravida.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1995

Reducing the frequency of episiotomies through a continuous quality improvement program.

OBJECTIVE: To determine the effectiveness of a continuous quality improvement (CQI) program in reducing episiotomy rates. DESIGN: Before-and-after study; CQI methods were used to examine the process of care during labour and birth. INTERVENTIONS: Identification of care factors that would increase the probability of episiotomy. Implementation of initiatives that would change the process of care to minimize the probability of episiotomy. Educational strategies included promotion of better understanding of what constitutes an appropriate episiotomy rate and ways to reduce maternal exhaustion and true fetal distress as well as manoeuvres to protect the perineum during birth. SETTING: Low-risk family practice obstetrics service in a tertiary care hospital in southwestern Ontario. PARTICIPANTS: All 102 family physicians at the study hospital who provided intrapartum care in the year before and the year during which the CQI program was implemented and the women for whom the care was provided (approximately 1,400 per year). OUTCOME MEASURES: Episiotomy rates (overall, among primiparous and multiparous women, and among individual family physicians) and rates of perineal tear, perineal infection and postpartum readmission. RESULTS: Although the planned reduction in the episiotomy rate was not achieved during the study period, the overall rate decreased significantly from 44.5% to 33.3% (p < 0.001). Among the primiparous women the rate decreased from 57.6% to 46.2% (p < 0.001) and among the multiparous women from 34.3% to 23.6% (p < 0.001). The reduced episiotomy rate among the primiparous women was associated with a significant decrease in the rate of third- and fourth-degree perineal tears and a significant increase in the number of women giving birth with an intact perineum or a minor (first-degree) tear. These benefits were not seen among the multiparous women, whose decreased episiotomy rate was associated with a significant increase in the number of women experiencing a second-degree perineal tear. During the intervention period, there was no increase in the rates of vaginal trauma or postpartum bleeding, infection or readmission because of complications related to perineal trauma. The episiotomy rates for most physicians decreased significantly during the intervention period. CONCLUSIONS: The CQI model may be useful in modifying clinical practices such as episiotomy because it focuses on understanding the process of care and the environment in which care is provided, both of which may have a major impact on physician behaviour. Further study is needed to ascertain the sustainability of the effects of this approach and which components of the model had the greatest effect.

Algorithms↗
PubMed1994

[A record-linkage study on risk factors for cause-specific infant mortality].

Infant death certificates were linked with birth certificates for infants born to residents of Tohoku, Tokai and Kyushu regions in 1989 (n = 409, 679, or about one-third of all births in Japan), to examine the effects of variables, as reported on birth certificates, on cause-specific infant mortality. "Certain conditions originating in the perinatal period" and "congenital anomalies" accounted for nearly 90 percent of neonatal deaths, while "congenital anomalies", "injuries and poisoning" and "sudden infant death" were responsible for about 65 percent of postneonatal deaths. Mortality rates for almost all causes of infant deaths, except injuries and poisonings, increased as birth weight decreased not only in the neonatal period but also in the postneonatal period. This suggests that low birth weight places some infants at higher risk of death, and conditions that lead to low birth weight independently contribute to the risk of infant death. Cox's proportional hazards linear model was used to assess the effects of variables on infant mortalities by causes of death. An extremely strong birth weight effect was noted for "certain conditions originating in the perinatal period" and "congenital anomalies". Being a male infant and late order of birth in multiparity were other risk factors for deaths from "congenital anomalies", while being a male infant, resident of Tohoku region and maternal stillbirth experience related to deaths from "certain conditions originating in the perinatal period". Elevated risks of sudden infant death syndrome (SIDS), of which mortality rate in Japan was considerably lower than those in most developed Western countries, i.e. 0.23 per 1,000 live births in 1989, were associated with low birth weight, being a male infant, low maternal age, late order of birth in multiparity and illegitimacy. Low maternal age, late order of birth in multiparity and illegitimacy, also, related significantly to increased risk of infant deaths for "injuries and poisoning". These results suggest the independent contributions of socioeconomic factors to infant mortality, especially postneonatal mortality, from SIDS, "injuries and poisonings".

Adult↗
PubMed1996

Event-time analysis of the effect of 60-day milk production on the parturition-to-conception interval in dairy cows.

OBJECTIVE: To quantify the effect of early-lactation milk and milk fat production on time to conception. DESIGN: Event-time analysis (survival analysis). SAMPLE POPULATION: 44,450 cows delivering calves between September 1985 and September 1986, from 6,227 Ayrshire dairy herds in 80 Finnish communities. PROCEDURE: Primiparous and multiparous cows were analyzed in separate Cox proportional hazards models. 60-day milk and milk fat production were categorized and regressed against days from parturition to conception for the period 56 to 120 postpartum days, controlling for season of parturition, parity, herd production, occurrence of 43 diseases, and community. RESULTS: Multiparous cows producing above the 80th percentile for 60-day milk, but with milk fat production below the 75th percentile, were significantly more likely to conceive, compared with cows with lower production and compared with cows with similar milk production but with milk fat between the 75th and 97th percentiles. They were slightly more likely to conceive than cows with highest milk fat production, although not significantly so. Primiparous cows producing above the 80th percentile for 60-day milk with milk fat below the 75th percentile also had the highest conception probability. The highest producing primiparae had significantly lower conception probability than all others. CONCLUSIONS: Controlling for disease occurrence, calving season, parity, herd production level, and community, there appeared to be an inverted U-shaped relation between 60-day production and conception probability. CLINICAL RELEVANCE: Primiparous cows that are high producers may not be receiving the same careful management that high-producing multiparous cows receive.

Aging↗
PubMed1996

Event-time analysis of the effect of season of parturition, parity, and concurrent disease on parturition-to-conception interval in dairy cows.

OBJECTIVE: To quantify the effect of season of parturition, parity, and various diseases on time to conception. DESIGN: Event-time analysis (survival analysis). SAMPLE POPULATION: 44,450 cows delivering calves between September 1985 and September 1986, from 6,227 Ayrshire dairy herds in 80 Finnish communities. PROCEDURES: Primiparous and multiparous cows were analyzed in separate Cox proportional hazards models for postpartum days 56 to 120. Occurrence of 43 diseases or disorders was recorded; codes were condensed into 25 variables offered to each model. Season of parturition was categorized into spring, summer, and fall-winter; for multiparous cows, 3 categorical variables represented parity. Models controlled for 60-day milk and milk fat production, herd milk production, and community. For all observations, parturition-to-conception interval was plotted against calendar day of parturition. RESULTS: For multiparous cows, parturition in the spring or summer and being of parity 2 or 3-4 (vs older) increased the chance of conceiving; 10 diseases or disorders decreased this probability. Similarly, in the model for primiparae, parturition in spring or summer increased the probability of conception, and 6 disorders decreased it. Disorders that were detrimental in both models were anestrus, ovulatory dysfunction, other infertility, late metritis, and clinical ketosis. CONCLUSIONS: The effect of season on the parturition-to-conception interval was marked at this latitude. Parturition during late April, causing confluence of postpartum day 55 with the summer solstice, was associated with the shortest parturition-to-conception intervals. Ketosis was found to be an important factor in lengthening the parturition-to-conception interval, highlighting the effect of negative energy balance on postpartum restoration of reproductive function.

Animals↗
PubMed1997

Pre- and post-weaning piglet performance, sow food intake and change in backfat thickness in a group-housing system for lactating sows.

Four farms that group-housed sows from about 2 weeks of lactation until weaning (G-farms) and 3 farms, used as controls, that kept the sows individually penned throughout the 5 to 6-week-long lactation period (C-farms) were compared in terms of pre- and post-weaning piglet growth rate and mortality, sow food intake and change in backfat thickness. Piglets from 169 G-farm sows and 136 C-farm sows were individually weighed at the time of grouping and weaning. In addition, some of the piglets were weighed 2 weeks post weaning. Piglet mortality was recorded during the pre- and post-weaning periods. Sow backfat thickness was measured at the time of grouping (at a corresponding time in the C-farms) and weaning, and sow food consumption was determined during the group-housing period. Piglet weight, growth rate and within-litter variation in growth rate did not differ significantly between the two groups during the group-housing and post-weaning periods. However, the pre-weaning growth rate varied considerably between farms. For multiparous sows during the group-housing period, piglet mortality was higher (p = 0.002) in the G-farm group (6.5%) than in the C-farm group (1.4%). However, for primiparous sows the corresponding piglet mortality was similar (p = 0.21) in the two groups. Significant between-batch variation in mortality during the group-housing period was noted within the G-farms but not within the C-farms. At the time of weaning, backfat thickness tended (p = 0.09) to be higher in the G-farm group than in the C-farm group. For primiparous sows the decrease in backfat thickness was similar (p = 0.37) in the two groups. By contrast, multiparous G-farm sows gained backfat during the group-housing period, whereas multiparous C-farm sows lost some backfat (p = 0.02). G-farm sows consumed 23% more food than C-farm sows during the group-housing period. These results indicate that productivity is lower in the group-housing system, mainly owing to the poor performance of the older sows.

Adipose Tissue↗
PubMed1976

Changes in the renin-angiotensin system in normotensive and hypertensive women during pregnancy and parturition.

Plasma renin activity, plasma renin concentration and plasma angiotensin II were measured in 18 primigravid women and 17 multiparous women between 37 and 42 weeks of gestation. Seven of the primigravid and seven of the multiparous women were admitted to hospital because they developed hypertension during pregnancy. In the primigravid group, the mean angiotensin II level was significantly higher in the hypertensive than in the normotensive women. A highly significant correlation was found between diastolic blood pressure and plasma angiotensin II levels. Although a similar trend was seen in the multiparous women, there was a wide scatter of values and the relationship between diastolic blood pressure and plasma angiotensin II was not significant. No correlation could be established between plasma renin concentration and angiotensin II levels. However, there was a trend towards a negative correlation between plasma renin activity and plasma angiotensin II, suggesting that high angiotensin levels may suppress renal renin release. The influence of parturition on plasma angiotensin II levels was investigated in 12 women. Maternal plasma angiotensin II levels were significantly higher in the second stage of labor than in women delivered by elective cesarean section.

Angiotensin II↗
PubMed1976

Fetal growth modified by natural and induced changes in maternal reactivity.

Maternal immunological unresponsiveness has usually been demonstrated with adult tissue allografts. Experiments were first directed to the question of whether maternal reactivity to allogeneic conceptuses parallels that of implants of allogeneic tumor. BALB/c female mice parous by C3H males for one to eight litters and challenged with Tumor 70429 of C3h origin showed increasing unresponsiveness with multiparity. A high percentage of progressively growing tumors in highly multiparous females indicates that unresponsiveness does not give way to sensitization. The effects of multiparity on placental and fetal weights in BALB/c females pregnant by C3H males resulted in a continuing decrease in placental weight (indicative of unresponsiveness) through the third pregnancy, but this was followed by a contrasting progressive weight increase indicating sensitization with four or more pregnancises. Syngeneic placentas displayed a similar pattern suggesting that weight changes were not entirely alloantigen dependent and that fetus-specific antigens also alter maternal reactivity. The effects of specific and nonspecific maternal preimmunization and specific parity on placental weights were tested as follows. One group of BALB/c females was immunized against C3H (specific), a second was immunized against DBA/2 (nonspecific), and a third was not immunized. Each of these groups was divided in half and mated to either C3H or DBA/2 males for a first litter; then all were mated to C3H for a second pregnancy. Placental weights were significantly smaller in females that had their first litter by C3H males. A similar experiment with BALB/c X C57BL F1 females resulted in fewer changes in placental weights. In all instances, maternal reactivity had its major effect upon placental rather than fetal weight. The effect of maternal unresponsiveness upon reproductive capacity was tested by mating BALB/c females to either DBA/2 POR C3H males for a first litter and then mating all females ot C3H males for a second litter. Second litters were significantly larger when first litters were also sired by C3H males.

Animals↗
PubMed1985

The "grand multipara"--is it a problem? A review of 5785 cases.

The Grand Multipara (GM) has almost disappeared in the Western countries due to the advancement of family planning. Having a heterogeneous population, the problem of Grand Multiparity still exists in our country. This study is based on 5785 cases of GM which were treated in our Obstetrical Department during a period of 16 years (1960-1975). We have compared this group to the general obstetrical population in terms of pregnancy and delivery complications. Face and breech presentations as well as transverse lie were twice, brow presentations were three times as frequent in the GM group. Postpartum hemorrhage (P.P.H.) was four times and premature separation of the placenta twice as frequent. Rupture of the uterus was about 20 times more frequent. Forceps delivery and Cesarean section rate were twice, while the vacuum extraction 5-fold more frequent. Though there was no material mortality and perinatal mortality was not higher than in the general population. Even though the percentage of GM in our population has been decreased in the last 10 years, our results suggest that Grand Multiparity is still a high risk obstetrical problem.

Female↗
PubMedDate not supplied

Tubal ligation in Milne Bay Province, Papua New Guinea.

Milne Bay Province, Papua New Guinea, with a scattered population of 130,000 suffers from irregular health patrols in remote areas, and often inadequate supplies of contraceptive agents. A total of 694 tubal ligations were performed by hospital staff under local anaesthesia between 1978 and 1982 in the province, the number increasing each year. Detailed analysis of 324 operations from 1979 to 1981 showed an average age of 34, average parity of 7 (84% of women had five or more children) and the presence of one or more high risk factors other than multiparity in half the women operated upon. Tubal ligation decreases maternal mortality, and has proven to be a useful method of family planning for multiparous women living in remote villages in Milne Bay Province.

Adult↗
PubMed1997

The Nova-T 200 intrauterine contraceptive device: a 12 year study.

AIM: To evaluate the long term clinical performance of the Schering Nova-T 200 intrauterine contraceptive device. METHOD: From 1982 to 1990, 446 women were fitted with their first Nova-T IUD's and followed up until December 1994. By this cut off data, 21 (4.7%) were lost to follow up. These were excluded to simplify analysis. RESULTS: Of the remaining 425 women, there were 383 multipara and 42 nullipara. Thirty one percent were fitted with a new Nova-T after 4 years of use. The method was uncomplicated in 70% of multiparous women, but in nulliparous users, the removal rate for unacceptable bleeding and/or pain was found to be 40% compared to 19% for the multipara. An expulsion rate of 4.9% was recorded. The overall cumulative accidental pregnancy rate was 3.5% with a Pearl Index of 1.2 per hundred woman years, a lower rate in older users being the only age related event in the study. Possible pelvic inflammatory disease was recorded in 2.8% with a Pearl index of 0.96. There was no evidence of subfertility after removal in any of the 53 women where a pregnancy was desired. CONCLUSION: The Nova-T 200 IUCD is safe and cost effective and should continue to be offered as a contraceptive option for properly selected women. Although poorly tolerated by nullipara, it proved to be very satisfactory for multiparous women, particularly nursing mothers and those over 40 years of age.

Adult↗
PubMedDate not supplied

Outcome of external cephalic version after 36 weeks' gestation without tocolysis.

OBJECTIVE: Despite its efficacy, external cephalic version (ECV) at term is not universally employed. Published series of Caucasian women are small and concerns regarding safety and spontaneous version remain. We review the outcomes of 26 months of a breech clinic in a Dublin teaching hospital. METHODS: All women with known breech presentation at 36+ weeks were referred unless another indication for cesarean section existed. Unstable lie, fetal compromise, antepartum hemorrhage, and patient refusal were the only contraindications to ECV. One operator attempted all versions, without tocolysis. RESULTS: Three hundred seventy women were referred and in 356 (95%), version was attempted at a mean gestation of 37 + 3 weeks; 195 (55%) were nulliparous and 161 (45%) were multiparous. The success rate was 43%, including 33% of nulliparous and 54% of multiparous women. There were three perinatal deaths (0.8%), all unrelated to the version. Minor complications were rare, although two women were delivered by cesarean section shortly after unsuccessful version. Ninety-three percent of successful versions were cephalic at delivery, as were 4% of unsuccessful versions; 12% of infants with a cephalic presentation after successful version were delivered by cesarean section. CONCLUSIONS: From this large series, ECV is extremely safe. Spontaneous version after unsuccessful ECV and reversion after successful ECV are unusual.

Adolescent↗
PubMed2004

Life-history correlates of steroid concentrations in wild peripartum baboons.

Steroid concentrations during late pregnancy and early lactation may be affected by both a female's reproductive history and her current condition, and may in turn predict subsequent life-history events, such as offspring survival. This study investigated these relationships in a wild primate population through the use of fecal steroid analysis in repeated sampling of peripartum baboons (Papio cynocephalus). Fecal samples were collected from 32 females in five groups within the Amboseli basin during 8 weeks prior to parturition and 13 weeks postpartum. From December 1999 through February 2002, 176 fecal samples were collected from individuals representing 39 peripartum periods. Fecal concentrations of progestins (fP), estrogen metabolites (fE), glucocorticoids (fGC), and testosterone metabolites (fT) were measured by radioimmunoassay. Steroid concentrations declined from late pregnancy to lactation, and the decline was greatest and most precipitous for fE and fP. Primiparous females had significantly higher mean fE concentrations in each of the last 2 months of pregnancy compared to multiparous females. Among multiparous females, fE and fT were significantly higher during late pregnancy in females carrying a male fetus compared to those carrying a female fetus. During early lactation, high fT in young mothers predicted subsequent infant death during the first year of life. These findings illustrate the potential power of repeated fecal-steroid sampling to elucidate mechanisms of life-history variability in natural populations. They also document significant differences in hormone profiles among subgroups, and highlight that such normative subgroup information is essential for interpreting individual variability in hormone-behavior associations.

Animals↗
PubMed1981

HLA antigens in Tükuna Indians.

Ninety-nine Tükuna Indians, inhabitants of the high Amazon, were typed for the HLA antigens. The method used was the microlymphocytotoxicity technique recommended by the NIH. At the same time, cross-matching was performed between the lymphocytes of the 99 Indians and the sera of 240 other multiparous Indians. Later the multiparous sera were cross-matched with a selected panel of Caucasoid individuals. The results showed that the most frequent antigens for th HLA-A locus were A2, Aw24 and Aw31. As for the HLA-B locus, B5, Bw39 and B40 were most frequent. The haplotypes HLA-Aw31-Bw39, and A2-B5 were in linkage disequilibrium. The results of the cross-matching showed 21.3% sera with positive reactions against Indian cells. Ten sera presented antibodies against known HLA antigens; five of them were monospecific, four had two specificities, and one showed three specificities. It was not possible to arrive at any conclusion about the 41 remaining sera. Six sera had positive reactions only with Indians cells.

Brazil↗
PubMed1990

Sources of variation in interbirth intervals among captive bonnet macaques (Macaca radiata).

Female fitness is a function of variation in the length of females' reproductive careers, the viability of their offspring, and the frequency with which they give birth. Infant loss shortens interbirth intervals in most primate species, but we know considerably less about other factors that contribute to variation in the length of interbirth intervals within groups. In one large captive group of bonnet macaques, maternal parity, age, experience, family size, and recent reproductive history are all associated with variation in the length of intervals that follow the birth of surviving infants. Primiparous females have the longest interbirth intervals, while multiparous females who have produced surviving infants in the past and have raised their last infant successfully have the shortest interbirth intervals. Infant sex and maternal rank have no direct effect upon the length of interbirth intervals. One of the underlying causes of variation in the length of interbirth intervals after surviving births seems to be variation in the timing of conceptions among females. Females who conceive early in the mating season tend to have shorter interbirth intervals than other females. However, females who are multiparous, experienced, and have recently raised infants have late conceptions and short interbirth intervals.

Age Factors↗
PubMed1976

A longitudinal analysis of maternal aggression in Rockland-Swiss albino mice.

Female Rockland-Swiss albino mice were treated for aggression during 6 successive pregnancies and lactation periods or until they ceased to re-mate. Fighting behavior was limited only to the lactation phase of each reproductive cycle. Although most animals exhibited fighting during every lactation period they completed, some exhibited fighting in some lactation periods but not in others. The intensity of aggression, as measured by the time spent fighting, was highest during the beginning of each lactation period and declined by the end of each period. Moreover, the intensity of aggression increased across the first 3 lactation periods and then declined on later lactation periods to a point below initial levels. Finally, the fighting behavior exhibited by multiparous animals was not due simply to previous fighting experience in that some multiparous mice exhibited postpartum aggression on the 6th lactation period in the absence of fighting experience during earlier lactation periods.

Aggression↗