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PubMedDate not supplied

Risk of postpartum induced abortion in Finland: a register-based study.

CONTEXT: Half of Finnish abortion patients already have children, and one in 10 pregnancies ending in abortions started within 12 months of a birth. Thus, many women may not practice contraception effectively during the postpartum period. METHODS: Data from national registers were used to create ajoint data file on pregnancies occurring in Finland over the period 1987-1998. The abortion risk (the risk of a conception that leads to an induced abortion) and abortion ratio (the number of conceptions leading to abortions divided by the number leading to deliveries) were analyzed in follow-up periods after all live births to women younger than 45 (684,922), using hazard regression and logistic regression. RESULTS: Pregnancies starting within eight months postpartum were more likely to end in abortion than were those starting later. Within the first eight months, the shorter the interval to the next pregnancy, the more likely the pregnancy was to end in abortion. Abortion risk was higher 6-18 months postpartum than at later periods and was highest at 6-8 months postpartum, particularly among unmarried women and teenagers. Between 1987-1988 and 1995-1996, the abortion risk within the first eight months postpartum rose significantly among women aged 25-29 and 30-34 (relative risks, 1.5 and 1.2, respectively). The abortion risk and abortion ratio were higher among teenagers than among women in other age-groups. CONCLUSIONS: The findings are consistent with the hypothesis that contraceptive practice is less effective postpartum, suggesting room for improvement in postpartum contraceptive counseling in Finland.

Abortion, Induced↗
PubMed2002

Coeliac disease is associated with intrauterine growth and neonatal infections.

UNLABELLED: To investigate whether factors in the fetal or neonatal period influence the risk of later development of coeliac disease we conducted a population-based register study. The Swedish Medical Birth Register was linked with the Hospital Discharge Register and identified 3392 singleton infants born in the period 1987-97 who developed coeliac disease. Perinatal data for these children were compared with all children born in these years. Exposure variables: Maternal age, parity and smoking habits in early pregnancy, preeclampsia, pregnancy duration and birthweight, birthweight by gestational week, Apgar score, neonatal icterus, neonatal infections, maternal-fetal blood group incompatibility, exchange transfusion, phototherapy. Odds ratios and test-based confidence intervals were calculated. Analyses were made with stratification for year of birth and other risk factors. The risk of developing coeliac disease decreased with maternal age and was lower in first-born than in second-born children. Maternal smoking in early pregnancy was a weak risk factor, as was low birthweight. The most evident risk factors were being exposed to neonatal infections (OR = 1.52, confidence limits 1.19: 1.95) and being small for gestational age (OR = 1.45, confidence limits 1.20; 1.75). These risk factors were independent of each other. CONCLUSIONS: We have demonstrated that the intrauterine environment, mainly as mirrored by a low birthweight for gestational age and, independently, neonatal infection diagnosis, is associated with the risk of developing coeliac disease, supporting the idea of a multifactorial aetiology of the disease.

Bacterial Infections↗
PubMed1978

Immunocytochemical localization of renin in the submandibular gland of the mouse during postnatal development.

The localization of renin in the developing mouse submandibular gland was studied immunocytochemically using the unlabelled antibody-enzyme method of Sternberger ('74). Bouin-fixed submandibular glands of mice of both sexes were examined at 5-day-intervals from birth (day 0) to 50 days of age. At all stages studied, only granular convoluted tubule (GCT) cells stained immunocytochemically for renin; such cells were first seen in glands of 30-day-old males and of 30-day-old females. The size and number of renin-containing GCT cells increased rapidly in males, attaining adult status by 50 days of age. In females, differentiation of GCT cells immunoreactive for renin was slower and less regular than in males, and at 50 days of age the GCT segment had not yet reached adult conditions with respect to the distribution of renin. Renin appears in GCT cells at later ages than other GCT cell products (e.g., EGF and amylase), suggesting the existence of independent developmental control for the expression of various biologically active substances in the GCTs.

Aging↗
PubMed2000

Intrinsic neurons in the rat ovary: an immunohistochemical study.

Previous studies have shown the presence of neuronal perikarya in the primate ovary, but not in the ovary from Sprague-Dawley rats. We report here that while such intrinsic neurons are indeed absent in this strain of rats, they can be visualized in the ovary from Wistar rats. The neurons, identified by their morphology and by the expression of NeuN (a neuron-specific nuclear protein), were detected at all postnatal intervals examined, from 14 h after birth to 50 days of age. While they were present in the ovarian hilum and medulla at all ages studied, neurons first appeared in the ovarian cortex during the juvenile period (postnatal days 10-20). In all cases, the size of the neuronal soma increased significantly during prepubertal development, reaching maximal values before puberty. Some neurons were catecholaminergic, as indicated by their content of immunoreactive tyrosine hydroxylase (TH), the rate-limiting enzyme of catecholamine biosynthesis. Some showed neuropeptide Y (NPY) immunoreactivity. TH-positive neurons were seen either in isolation or clustered in ganglion-like structures in both the ovarian cortex and medulla. These results indicate that ovarian neurons are not present in all strains of rats, but when present, the chemical phenotype of some of them is of a sympathetic nature, similar to that described in primates.

Animals↗
PubMedDate not supplied

Behavioral interaction of fathers with infants and mothers in the immediate postpartum period.

This study describes paternal behaviors of first-time fathers with their partner and newborn immediately after birth and identifies a progression of behaviors with the infant within the first 15 minutes after birth. Videotapes were made of 24 first-time fathers observed at birth a traditional delivery room setting. Utilizing an ethological approach to define behavioral codes, episodes of paternal behavior were measured with time interval sampling. Using a modified frequency method, behaviors were identified in four main categories: proximity, gaze, touch, and movement. The analysis showed that proximity and gaze were high-frequency behaviors and touch and movement were low-frequency behaviors. A progression of behaviors was identified, with gaze starting out high and diminishing, proximity and movement increasing over time, and touch remaining low but constant. Limitations of the setting and implications for clinical practice and research are discussed.

Father-Child Relations↗
PubMed1991

Lambing and placental expulsion time after dexamethasone-induced parturition in Corriedale and Polwarth ewes.

To study breed differences in ewes induced to parturition with dexamethasone (DXM), 15 Corriedale and 16 Polwarth ewes were injected with 15 mg of DXM four days before the expected lambing date (Days 144 and 145, respectively) in Experiment 1. Interval from treatment to parturition was twice as long for the Polwarth than for the Corriedale breed (57.9 vs 28.8 hours, P </= 0.001). In Experiment 2, the effect of DXM on the interval from parturition to expulsion of the placenta and on biological parameters of the lambs (birth weight, ability to stand after birth and daily weight gain during the first week of life) was studied in 30 Corriedale ewes. On Day 144 of gestation, ewes were given 15 mg of DXM (n= 22) or 15 ml of saline (controls, n= 8). The DXM group lambed 33.8 +/- 2.7 hours after injection. Treatment caused an increase in the time of placental expulsion (4.3 vs 3.4 hours, P>/= 0.05) and on the percentage of ewes retaining the placenta beyond 6 hours (18% vs 0%, P>/= 0.05). Birth weight of lambs was lower in the induced group (3.9 vs 4.5 kg, P</= 0.03), but this did not affect the other parameters of the lambs studied.

Journal Article↗
PubMed2002

Breast cancer risk in healthy and symptomatic women: results of a multivariate analysis. A case-control study.

Several risk factors for breast cancer (BC) have been investigated in different reports, but none has been really useful in preventing BC development. The aim of this study was to evaluate the risk of BC in self-selected symptomatic women in comparison with the healthy population residing in an urban area of Italy. A group of 404 women (median age 59 years, range 26-89 years) with confirmed BC (cases) were age-matched with 389 healthy women (Group A), and 391 (Group B) symptomatic non-screened patients without BC, who were referred to our Breast unit. The results of univariate analysis showed a significant (P < 0.01) difference between cases and controls in (1) age at menarche, (2) number of birth and age at first births, (3) lactation and months of lactation, and (4) estrogen replacement therapy (ERT) and duration of ERT. Multivariate analysis using a logistic regression model adjusted for age showed that five independent parameters (no pregnancy, age at first birth > 30 years, no lactation, use of ERT, ERT > 40 months) significantly (P < 0.01) correlated with BC onset. The relative odds ratios (ORs) at 95% confidence interval (95% CI) were 5.25, 2.47, 2.82, 2.80, and 5.56, respectively. The cumulative OR (95% CI) calculated from the observed vs. predicted values was 7.15. No differences (P = NS) were found between groups A and B. In conclusion, in our study population, the prolonged use (> 40 months) of ETR in menopausal women resulted in an increased risk of BC, and represented the only risk factor that could be removed.

Adult↗
PubMed1998

Maturation of peripheral and brainstem auditory function in the first year following perinatal asphyxia: a longitudinal study.

Maturation of peripheral hearing and auditory brainstem following perinatal asphyxia was investigated by longitudinal recording of brainstem auditory evoked potentials (BAEP) during the first year of life in affected infants. The general maturational course of the BAEP following asphyxia was similar to that in a control group of infants with normal births, although there were some abnormalities in the BAEP Response threshold elevation seen in a few asphyxiated infants improved significantly during the first 3 months. The interpeak intervals in the asphyxiated infants did not differ significantly from that of the control-group infants except in the first month, when the I-V and III-V intervals were significantly prolonged in the severe asphyxia group. In contrast, wave V amplitude and V/I ratio were always smaller when compared to that of the control-group infants. Amplitude reduction of wave V was more sustained than the prolonged I-V interval. Persistent hearing loss and brainstem auditory impairment were seen in 6.8% and 14.6% of the asphyxiated infants, respectively. These findings suggest that asphyxia does not interfere significantly with the maturation of the auditory system in most asphyxiated infants and that sustained peripheral hearing loss and brainstem impairment occur only in a small proportion of affected infants.

Age Factors↗
PubMed1990

[Incidence and prognosis of breast cancer in young women in relation to changes in the risk factor profile].

Trends in breast cancer incidence in women aged 25-44 years are assessed in detail based on data from the population-based cancer registry of Saarland-Germany. Compared to 1968-72, from 1978-82 and 1983-87, a highly significant increase in age-standardised incidence by more than 30% was observed. The increase in incidence was most pronounced among women of 25-29 years of age (relative incidence rate 1978-87, compared to 1968-77: 2.03, 95% confidence interval: 1.11-3.71). The role of changes in prevalence of known and suspected risk factors, mainly the age at the onset of menarche, the age at first birth, parity and early and long-term use of oral contraceptives in adolescence, which may partly explain the observed trends, are discussed. The results have important public health implications, such as the need for extended cancer surveillance and epidemiologic research in the Federal Republic of Germany, and offer a quantitative basis for the development and implementation of future early detection programmes as well as the need for medical care facilities.

Adult↗
PubMed1993

Surgically related upper cervical spine canal anatomy in children.

MRI studies of the upper spines of 121 children were evaluated to precisely define the sagittal anatomy at C1 in the pediatric population. The diameters of the spinal cord, bony canal, space available for the cord (SAC), dens+atlanto-dens interval (ADI), and "free" space were measured. The results demonstrate an accelerated growth in the C1 canal, dens + ADI, and SAC during the first four years after birth. Steel's rule of thirds was shown to roughly hold true throughout childhood. Neonates have an average SAC diameter of 12.4 mm, a value less than the 13 mm dimension commonly used to define relative stenosis in children.

Adolescent↗
PubMed2006

Maternal and paternal influences on length of pregnancy.

OBJECTIVE: Biological evidence suggests that both mother and fetus are involved in triggering a normal delivery. A tendency of a child to have a gestational age at birth similar to the father's could represent the effect of genes passed from the father to the fetus. Similar tendencies between mother and child could represent maternal genes passed to the fetus, as well as genes to the mother received from the grandmother that affect a woman's capacity to carry a pregnancy. METHODS: The Medical Birth Registry of Norway contains data on all births in Norway from 1967 onward. We identified 77,452 pairs of boys and girls born at term who later became parents and linked their birth data to the birth records for their first child. RESULTS: Gestational age of the child at birth increased on average 0.58 days for each additional week in the father's gestational age (95% confidence interval 0.48-0.67) and 1.22 days for each additional week in the mother's gestational age (1.21-1.32). Gestational age was, however, 0.65 days reduced for each additional kilogram in the father's birth weight, presumably due to more rapid growth of the fetus triggering delivery. CONCLUSION: Initiation of delivery has a fetal component that is heritable (passed from father and mother to child) and an additional maternal component that is also heritable. In addition, a more rapid rate of fetal growth appears to trigger delivery at earlier gestation. LEVEL OF EVIDENCE: II-2.

Adult↗
PubMed1987

Endocrine and body growth traits in heifers exposed to testosterone-propionate during early fetal development.

This study was conducted to determine the effects of testosterone-propionate exposure during fetal development on sexual differentiation and growth rates in heifers. Ten pregnant cows were given subcutaneous injections of testosterone-propionate (250 mg/injection) every other day during d 40 to 60 of gestation. Four cows aborted after the end of testosterone treatment, while four heifers (androgenized females) and two bulls (androgenized males) were produced from the six remaining pregnant, testosterone-propionate treated cows. Calves from cows that did not receive exogenous hormone treatment were used as controls. At 8 mo of age, the androgenized heifers and control heifers and control steers were challenged with 1 mg estradiol-17 beta to induce a preovulatory luteinizing hormone (LH) surge. Two weeks later, pituitary responsiveness to exogenous luteinizing hormone releasing hormone (LHRH; 75 micrograms) was evaluated in androgenized heifers and in control heifers and control steers. To monitor growth rates, all animals were weighed at 28-d intervals from birth to 380 d of age. Androgenized females exhibited a partially masculinized phenotype as well as internal male reproductive structures. Treatment with estradiol-17 beta first depressed (P less than .05) serum LH concentrations in all animals, then induced (P less than .05) a preovulatory-like LH surge in control and androgenized females. Control steers did not (P greater than .05) exhibit a preovulatory-like LH surge following administration of estradiol-17 beta. Exogenous LHRH treatment stimulated peak LH concentrations (P less than .05) to a greater extent in control and androgenized females than in control steers.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Recurrent first trimester spontaneous abortion associated with antiphospholipid antibodies: a pilot study of treatment with intravenous immunoglobulin.

BACKGROUND: Antiphospholipid antibodies, unassociated with an underlying connective tissue disease, have repeatedly been detected in women suffering from recurrent spontaneous abortions. Several therapeutic regimens have been advocated for pregnant women with recurrent fetal loss and antiphospholipid antibodies. However, most of these approaches were empirical, using several drugs simultaneously, and most reports describe single cases or limited series. PATIENTS AND INTERVENTIONS: In a pilot study, thirty-eight women with a history of three or more consecutive first trimester spontaneous abortions and antiphospholipid antibodies were treated with intravenous immunoglobulin. As soon as pregnancy had been confirmed, intravenous immunoglobulin was administered at a dose of 300 mg/kg bodyweight, and infusions were repeated at three-weekly intervals until the 16th-17th week of pregnancy. RESULTS: Pregnancy proceeded beyond the first trimester in 34 of the patients (89.4%), and 31 patients (81.4%) gave birth to healthy infants at 37 to 42 weeks' gestation. CONCLUSIONS: Although the results are promising, randomized placebo-controlled trials are necessary to exclude the influence of other factors (e.g. intense obstetric supervision and psychological factors) on pregnancy outcome and confirm the effectiveness of intravenous immunoglobulin in patients with recurrent spontaneous abortions and antiphospholipid antibodies.

Abortion, Habitual↗
PubMed1977

Application of immunofluorescence to the establishment of an Encephalitozoon cuniculi-free rabbit colony.

Serologic screening of a rabbit breeding colony over a 9-month period showed that all 9-week-old rabbits with Encephalitozoon cuniculi infection were born of E cuniculi-infected does. This observation, obtained from studies on 395 young rabbits, suggested that transmission of infection is either transplacental or the result of close contact soon after birth. On this basis, 16 young healthy rabbits, seronegative to E cuniculi, were isolated and tested at 2-week intervals for antibodies to E cuniculi. In the first 2 months, seven rabbits showed indications of developing antibodies to E cuniculi and were immediately removed from the colony. The remaining rabbits along with their 52 offspring were tested for serum antibodies for a further 16 months and no rabbit became seropositive. Eight months after establishment of the colony, three does, one buck and six 12-week-old rabbits were killed. Macroscopic and extensive histologic and immunofluorescence examinations failed to reveal any evidence of infection with E cuniculi. These results showed that serological screening for E cuniculi infection by immunofluorescence is a simple yet adequate procedure for establishing a rabbit colony free of encephalitozoonosis.

Animals↗
PubMed1977

[Prognostic value of the EEG in pre-term and full-term babies (author's transl)].

Looking for long-term prognostic value of the neonatal EEG, 545 records from 125 children in the pre-term and full-term period have been checked for special criterias: 1. Periods of electrocerebral inactivity (with usual amplifier gain) 2. Relative amplitude reduction over one of the hemispheres or localized 3. Focal changes 4. Epileptic activity: focal, multifocal and generalized. 5. Unspecific rhythm of alpha- and epsilon-frequency, which can not be classified as epileptic seizure pattern. According to the pronounciation of these criterias the EEG records were classified as severely, medium, severely, moderately abnormal and as normal. Comparison was done with the results of the last control EEG and the last clinical control examination. The principal results are: 1. Children with severe EEG abnormalities have a high mortality rate (about 70%). Long periods of electrocerebral inactivity are more unfavourable quoad vitam than epileptic discharges. 2. Late sequelae as cerebral palsy, psychomotor retardation and epilepsy are to be expected in all children with severe EEG abnormalities remaining alive and in many children with medium severe EEG abnormalities. 3. The rate of normal psychomotor development increases with the decrease of EEG abnormalities. It is important to mention: 1. EEG records in the first hours and days after birth give the best information regarding a long-term prognosis. 2. In children remaining alive and not developing hypsarrhythmia the observation interval must be more than one year for an estimation of probable electroencephalographic and clinical outcome.

Asphyxia Neonatorum↗
PubMed1997

Characteristics of women with and without breast augmentation.

OBJECTIVE: To compare selected characteristics of women with and without augmentation mammaplasty to identify differences between these 2 groups of women. DESIGN AND STUDY PARTICIPANTS: White women identified as controls in previously conducted population-based, case-control studies formed the study population for the present cross-sectional analysis (N=3570). MAIN OUTCOME MEASURE: Interview information on selected characteristics was compared between women who had received augmentation mammaplasty (n=80) and other women (n=3490) using the prevalence odds ratio (pOR) as the measure of association. RESULTS: Women with breast implants were more likely to drink a greater average number of alcoholic drinks per week (for > or =7 drinks vs 0 drinks: pOR=2.9, 95% confidence interval [CI]=1.5-5.5), be younger at first pregnancy (for age <20 years vs age 20-29 years: pOR=1.6, 95% CI=1.0-2.7), be younger at first birth (for age <20 years vs age 20-29 years: pOR=1.9, 95% C1=1.1-3.3), have a history of terminated pregnancies (for > or =1 termination vs 0 terminations: pOR=2.0, 95% CI=1.2-3.4), have ever used oral contraceptives (pOR=2.2, 95% CI=1.0-4.7), have ever used hair dyes (pOR=4.5, 95% CI=1.3-15.4), and have had a greater lifetime number of sexual partners (for > or =14 partners vs < or =4 partners: pOR=8.9, 95% CI=3.1-25.5) than other women. A history of smoking, lactation, high blood pressure, or thyroid disorders, as well as the number of pregnancies, full-term births, or miscarriages, differed little between women with and without implants. Women with breast augmentation were much less likely to be heavy than other women (for > or =74 kg vs <56 kg: pOR=0.1, 95% CI=0.03-0.3). CONCLUSION: The differences we found between women with and without breast implants suggest that consideration and evaluation of confounding factors in future studies will help to clarify some of the long-term health consequences of having breast implants.

Adult↗
PubMed1999

Factors associated with fear of delivery in second pregnancies.

OBJECTIVE: To identify factors associated with fear of childbirth during and after first labor. METHODS: We analyzed first deliveries of 100 primiparas who reported severe fear of vaginal childbirth during their second pregnancies and 200 age- and parity-matched controls who reported no later fear of delivery. The main outcome measures were previous miscarriages, participation in birth-education classes, support during labor, length of first delivery, pain relief, obstetric complications, welfare of the newborn, and time between deliveries. RESULTS: The prevalence of emergency cesarean (adjusted odds ratio [OR] 26.9, confidence interval [CI] 11.9, 61.1) and vacuum extraction (adjusted OR 4.5, CI 2.2, 9.3) during first delivery was much higher in subjects than controls. Labor lasted longer in cases than in controls during the first (10.5 hours versus 7.8 hours, P = .016) and second stages (62 minutes versus 47 minutes, P = .002). They received epidural analgesia more often, but its timing and the amount used were not different between groups. Of the group with fear, 44% could not define any specific cause for fear and regarded the entire delivery as frightening. CONCLUSION: Emergency cesarean and vacuum extraction during first deliveries were associated with secondary fear of delivery. Emergency obstetric procedures cannot be avoided, so prevention of fear might require more education on causes and consequences of cesarean or vacuum extraction, eg, in birth classes and at postpartum visits.

Adult↗
PubMed1995

The effect of tocolytic use in the management of symptomatic placenta previa.

OBJECTIVE: The null hypothesis is that tocolysis has no effect on pregnancy prolongation in the aggressive expectant management of symptomatic preterm placenta previa. STUDY DESIGN: One hundred twelve preterm pregnancies with confirmed placenta previa and an initial episode of acute vaginal bleeding were selected for this retrospective analysis. Exclusion criteria included gestational age > or = 35 weeks, delivery within 24 hours of admission, prior treatment for bleeding or preterm labor, and contraindications to tocolytic use. Tocolysis was prescribed, at the discretion of the treating clinical staff, in selected pregnancies with significant uterine contractions after admission of the patient. The majority of treated patients (85%) received intravenous magnesium sulfate and/or oral or subcutaneous beta-sympathomimetics within 24 hours of admission. Most patients remained hospitalized until delivery under this aggressive expectant management protocol. Both treated and untreated control study groups were similar at inclusion with regard to parity, gestational age, contraction frequency, and degree of initial bleeding. Outcome variables for each treatment group were obtained from final chart review. Continuous and categoric variables were compared with Student t test or chi 2 analysis-Fisher's exact test, respectively. RESULTS: The clinical use of tocolysis in symptomatic placenta previa was associated with a clinically significant delay of preterm delivery. Significant improvement in clinical parameters such as interval from admission to delivery (39.2 vs 26.9 days, p < 0.02) and birth weight (2520 vs 2124 gm, p < 0.03) was observed in the tocolysis group. There was no observed statistical difference between the two treatment groups with regard to incidence of recurrent bleeding, interval from admission to first recurrent bleeding, and need for transfusion. There was a trend for patients with multiple bleeding episodes to have been receiving tocolytic therapy (p < 0.10). A trend for requiring a postpartum transfusion was also noted in the tocolysis group (p < 0.09). Treated pregnancies receiving long-term maintenance tocolysis with oral or subcutaneous terbutaline exhibited a greater degree of pregnancy prolongation than those treated with short-term intravenous magnesium alone (43.7 vs 15.3 days, p < 0.02). CONCLUSIONS: This retrospective analysis suggests that tocolytic intervention in cases of symptomatic preterm previa may be associated with clinically significant prolongation of pregnancy and increased birth weight. Tocolytic therapy in these cases does not appear to have an impact on frequency or severity of recurrent vaginal bleeding. Further prospective analysis may delineate the role of tocolysis in the aggressive expectant management of symptomatic placenta previa.

Adult↗