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At least 829 records · Page 46Linked to original sources
PubMed2006

Assessment of reproductive parameters in female Dwarf goat (Capra hircus) on the basis of progesterone profiles.

A study was undertaken to look into the reproductive performance of female Dwarf goats reared under traditional conditions at NIAB Farm, Faisalabad, Pakistan. The serum progesterone profile was used to monitor various reproductive parameters (length of postpartum period, resumption of cyclicity, gestation period, prepartum period, parturition) in two lots of goats. Litter size, birth weight of kids and kidding interval were also observed. Most of the animals conceived within 15-59 days of postpartum period. All the does conceived at first or second estrus. During gestation period, higher levels of progesterone were maintained with wide variations falling in the range of 3-13 ng ml(-1). However, a few days before parturition a decline was noticed at 6+/-0.9 days and it reached to the basal level of 0.1 ng ml(-1) after the completion of parturition process. The length of gestation period was found to be 145.8+/-5 days in the first lot and 145.2+/-4 days in the second lot. A very short kidding interval (203.7+/-46 days) and considerably bigger litter size (1.8+/-0.8) was observed. All the parturitions were normal and a considerable weight gain (8.2+/-0.3 kg) of mothers was recorded during pregnancy. The initial birth weight of kids was averaged as 2.1+/-0.5 kg in the first and 1.6+/-0.2 kg in the second lot. It was concluded that Dwarf goat has short gestation length, postpartum period and kidding interval along with multiple births being common. Due to these factors, its reproductive efficiency can be exploited for efficient goat meat production.

Animals↗
PubMed1997

Preeclampsia and preterm birth subtypes in Nova Scotia, 1986 to 1992.

The goal of this study was to evaluate the influence of preeclampsia on preterm delivery, examining whether the association varied among preterm birth subtypes defined by gestational age and precipitating events. A population-based, longitudinal study of the association between mild and severe preeclampsia and preterm birth subtypes was conducted among 59,851 women (resulting in a total of 78,086 pregnancies) delivering singleton live births in the province of Nova Scotia, Canada between 1986 and 1992, utilizing the Nova Scotia Atlee perinatal database. Very preterm (< 33 weeks' gestation) and moderately preterm (33-36 weeks' gestation) births were further classified as occurring due to (1) membrane rupture, (2) medical intervention, and (3) spontaneous onset of labor (before membrane rupture). Mild and severe preeclampsia occurred in 8.7 and 1.7% of pregnancies, respectively, after exclusions of multiple births. After adjustment for confounders by multivariable logistic regression based on the generalized estimating equations, severe preeclampsia was strongly associated with the risk of very preterm birth (RR = 80.8, 95% CI: 54.2-120.6), and moderately preterm birth (RR = 41.8, 95% CI: 34.0-51.4) due to medical intervention. A less dramatically elevated risk of very preterm (RR = 2.1, 95% CI: 1.1-4.0) and moderately preterm (RR = 2.2, 95% CI: 1.7-2.9) birth due to medical intervention was apparent among pregnancies complicated by mild preeclampsia. Very preterm births due to membrane rupture were too rare to examine, but moderately preterm births due to membrane rupture were not associated with preeclampsia. Preeclampsia was associated with an increase in the risk of moderately preterm births due to spontaneous labor (RR = 1.9, 95% CI: 1.3-2.8), but not very preterm births (RR = 1.0, 95% CI: 0.7-1.2). Substantial variability was observed in the association between preeclampsia and preterm birth in relation to the subtypes defined by gestational age and pathway, with strong associations between hypertension and medically induced preterm births. The results indicate a need to separate preterm births into subcategories to properly evaluate the association between preeclampsia and preterm births and interventions to reduce the adverse effects of preeclampsia.

Adult↗
PubMed1997

Are sociodemographic factors predictive of preterm birth? A reappraisal of the 1958 British Perinatal Mortality Survey.

OBJECTIVE: Reassessment of the predictive value of sociodemographic factors on preterm birth. DESIGN: Population-based case-control study. SETTING: England, Wales and Scotland. SAMPLE: The study sample consisted of 5630 primiparous and 9538 multiparous women who were delivered during the first week of March 1958 in Britain. Multiple births were excluded. METHOD: Factors potentially predictive of preterm birth were assessed for primiparous and multiparous women separately, using the split-sample cross-validation technique. MAIN OUTCOME MEASURE: Preterm birth, defined as birth occurring before 259 days of gestation. RESULTS: Preterm birth rates for primiparous and multiparous women were 54 and 53 per 1000 births, respectively. In primiparous women low maternal age (under 20 years) was the only sociodemographic variable that was predictive of preterm birth (P = 0.01). However, only 10.7% of preterm birth among primiparous women was associated with low maternal age. In multiparous women, using univariable analysis, employment status was statistically significantly associated with preterm birth. This association disappeared when employment status was adjusted for by other variables in the model. Social class was not predictive of preterm birth in either primiparous or multiparous women. CONCLUSION: From the results of this study it is concluded that sociodemographic factors do not have a substantial impact on the risk of preterm birth. It seems unlikely that preventative measures aimed at social-demographic adversity will reduce preterm birth rates.

Case-Control Studies↗
PubMed1996

Plasma somatostatin and cholecystokinin levels in preterm infants during the first day of life.

Our knowledge about regulatory gut peptides in preterm infants is scanty. We therefore began a study of plasma somatostatin (SS) and cholecystokinin (CCK) in preterm infants at birth and during the neonatal period. Plasma SS and CCK levels were assessed in 77 mothers and in 91 preterm infants immediately after birth (umbilical cord) and during the first day of life (1F) (n = 69, median age 5 h). The gestational age ranged from 23 to 36 weeks and the birth weight from 460 to 3,350 g. After Sep-Pak C18 semichromatography of plasma, SS and CCK were analyzed by RIA. Both plasma SS and CCK levels increased significantly during the first hours of life. Plasma SS levels were negatively correlated to gestational age, birth weight and birth length. When the SS-1F levels were adjusted for gestational age in a multivariate analysis there was no independent association with birthweight but a weak association with birth length. Plasma CCK-1F levels were not correlated with any of these variables. Plasma SS-1F levels were lower after cesarean section. Plasma SS and CCK levels during the first day were not correlated to multiple birth, mode of anesthesia, umbilical pH, Apgar score and blood glucose level before first meal.

Adolescent↗
PubMed2002

Population based ascertainment of twins and their siblings, born in Western Australia 1980 to 1992, through the construction and validation of a maternally linked database of siblings.

This paper describes the creation of a unique maternal identifier for use in the investigation of perinatal, postneonatal and child outcomes in relation to maternal characteristics. All Midwives' records of Western Australian (WA) births were routinely linked to registrations of births and deaths for infants born from 1980 to 1992 inclusive, then linked to WA hospital discharge data and to registries of birth defects and cerebral palsy to create a longitudinal health record for each infant. However, since each birth to a woman was recorded as a separate event, there was no way to identify siblings. Probabilistic record linkage, based on information about the mother, was used for this task. Logical inconsistencies within the data were used to test the validity of the linkages between birth records attributed to each mother. Information about the mother from other epidemiological studies and data abstracted from hospital case notes was also used to validate sibships. Linkage of the records of 310,255 births in WA during that period resulted in the formation of 181,133 sibships of one or more children. Pooling the results of all of the validation methods gave an error of 0.9%. Linkage identified 3678 sibships containing multiple births, and 305 sets of maternal twins. Ascertainment of twins and their siblings for an ongoing twin register, the WA Twin Child Health (WATCH) study, was a natural consequence of this process.

Bias↗
PubMed1999

Infant mortality statistics from the 1997 period linked birth/infant death data set.

OBJECTIVES: This report presents 1997 period infant mortality statistics from the linked birth/infant death data set (linked file) by a wide variety of maternal and infant characteristics. METHODS: Descriptive tabulations of data are presented. RESULTS: In general, mortality rates were lowest for infants born to Asian and Pacific Islander mothers (5.0), followed by white (6.0), American Indian (8.7), and black (13.7) mothers. Infant mortality rates were higher for Puerto Rican mothers (7.9) than for Mexican (5.8), Cuban (5.5), Central and South American (5.5), or non-Hispanic white mothers (6.0). Infant mortality rates were higher for those infants whose mothers began prenatal care after the first trimester of pregnancy, were teenagers or 40 years of age or older, did not complete high school, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. In 1997, 65 percent of all infant deaths occurred to the 7.5 percent of infants bom at low birthweight. The three leading causes of infant death--Congenital anomalies, Disorders relating to short gestation and unspecified low birthweight (low birthweight), and Sudden infant death syndrome (SIDS) taken together accounted for nearly one-half of all infant deaths in the United States in 1997. Cause-specific mortality rates varied considerably by race and Hispanic origin. For black mothers, the infant mortality rate for low birthweight was four times that for white mothers. For American Indian mothers, the SIDS rate was 2.4 times that for white mothers. For Hispanic mothers, the SIDS rate was one-third lower than that for non-Hispanic white mothers.

Adolescent↗
PubMed1980

The use of human gonadotropins for the induction of ovulation in women with polycystic ovarian disease.

During the years 1974 to 1977, a total of 77 treatment cycles of human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG) were administered to 41 infertile patients with polycystic ovarian disease who failed to conceive on clomiphene. Twenty-seven patients (65.9%) conceived, two of them twice, making twenty-nine pregnancies. The abortion rate was 24.1% and the multiple pregnancy rate was 36.3%. Of the 77 treatment cycles, 7.8% were complicated by mild hyperstimulation and 3.9% by severe hyperstimulation. In six treatment cycles (7.8%), ovulation occurred spontaneously prior to the hCG injection. hMG-hCG is an additional safe and effective, nonsurgical treatment for women with polycystic ovarian disease who have failed to respond to clomiphene therapy. The reaction to exogenous gonadotropins is unpredictable and probably depends on the stage of follicular development prior to the stimulation. Therefore, daily estrogen determinations from the 1st day of treatment are mandatory in order to avoid hyperstimulation and/or multiple births.

Adult↗
PubMed1998

Strategies to prevent multiple pregnancies in assisted conception programmes.

All assisted conception techniques are associated with an increase in the multiple pregnancy rate. Iatrogenic multiple births are increasing as the use of these technologies expands. The cornerstone of safe ovulation induction is careful ultrasound monitoring, with cancellation of cycles if excessive ovulation is expected. In in vitro fertilization (IVF) cycles, the main determinant of multiple pregnancy risk is the number of embryos replaced. The current move in IVF clinics is to reduce the risk of multiple pregnancy by reducing the number of embryos transferred. We would suggest a maximum of two embryos transferred to women under, for example, 39 years of age. Women of 39 years or over have a reduced chance of embryo implantation; they should be allowed the transfer of up to three embryos (the UK legal maximum).

Clomiphene↗
PubMed1998

Obstetric care and proneness of offspring to suicide as adults: case-control study.

OBJECTIVE: To investigate any long term effects of traumatic birth and obstetric procedures in relation to suicide by violent means in offspring as adults. DESIGN: Prospective case-control study. SETTING: Stockholm, Sweden. SUBJECTS: 242 adults who committed suicide by violent means from 1978 to 1995, and who were born in one of seven hospitals in Stockholm during 1945-80, matched with 403 biological siblings born during the same period and at the same group of hospitals. MAIN OUTCOME MEASURES: Adverse and beneficial perinatal factors expressed as relative risks (odds ratios) and 95% confidence intervals, derived from logistic regression of cases matched with their siblings. RESULTS: For multiple birth trauma the estimated relative risks of offspring subsequently committing suicide by violent means were 4.9 (95% confidence interval 1.8 to 13) for men and 1.04 (0.2 to 4.6) for women. In mothers who received multiple opiate treatment during delivery, the estimated relative risk of offspring subsequently committing suicide was equal for both sexes (0.26, 0.09 to 0.69). CONCLUSION: Minimising pain and discomfort to the infant during birth seems to be of importance in reducing the risk of committing suicide by violent means as an adult.

Adult↗
PubMed1996

Maternal alcohol use and risk of orofacial cleft birth defects.

Maternal alcohol use during pregnancy is a known cause of birth defects associated with the fetal alcohol syndrome, but its role in more common, isolated, craniofacial birth defects is not well understood. A population-based, case-control study of orofacial clefts was conducted in Iowa using births during 1987-1991. Cases were identified by the Iowa Birth Defects Registry and classified as having a cleft lip with or without cleft palate (CLP) or cleft palate only (CP) and whether the cleft was isolated or occurred with other birth defects. Controls were selected from normal Iowa births. Maternal alcohol use during pregnancy was classified according to self-reported drinks consumed per month. Results are based on 302 controls and the following numbers in each case group: 118 isolated CLP, 56 isolated CP, 51 CLP with multiple defects, and 62 CP with multiple defects. Compared to women who did not drink alcohol during pregnancy, the relative odds of isolated CLP rose with increasing level of maternal drinking as follows: 1-3 drinks per months, 1.5; 4-10 drinks per month, 3.1; more than 10 drinks per month, 4.7 (chi-square test for trend, P = 0.003). Adjustment for maternal smoking, vitamin use, education, and household income did not substantially alter these results. No significant association was found between alcohol use and isolated cleft palate or clefts in children with multiple birth defects. Alcohol use during pregnancy may be a cause of isolated cleft lip with or without cleft palate.

Adult↗
PubMed1995

Sex selection may be inadvertently performed in in-vitro fertilization-embryo transfer programmes.

The present study aims to ascertain whether sex selection may be inadvertently performed in human in-vitro fertilization (IVF) and embryo transfer (IVF-embryo transfer) programmes when selecting for high quality embryos (those with the fastest cleaving rates and/or the best morphology) at the fresh transfer cycle. All patients entering into the study were treated with gonadotrophins after pituitary suppression with gonadotrophin-releasing hormone agonists (GnRHa) and had intrauterine embryo transfer on day 2 post-insemination. These patients were retrospectively divided into three groups according to whether the difference in mean number of cells between embryos transferred and all embryos available for transfer in a given cycle was less than (negative selection), equal to (no selection) or greater (positive selection) than zero. In cycles resulting in singleton births, the sex ratio of the resulting babies was significantly (P < or = 0.005) shifted toward the female (88.8%) and to the male (90.0%) in the negative and positive selection groups respectively. No shift in sex ratio was observed in cycles resulting in multiple births. Maternal age was another independent factor affecting sex ratio at birth. Sex ratio was significantly (P < or = 0.05) skewed in favour of males (62.7%) and females (71.4%) in women < 35 and > or = 35 years of age respectively. Maternal age, number of embryos transferred and the event of selecting or not selecting the slowest cleaving embryos for transfer were entered automatically in a three-group discriminant model for distinguishing cycles resulting in only boys, both boys and girls, and only girls. These data suggest that (i) sex selection may be inadvertently performed in IVF-embryo transfer programmes when selecting for high quality embryos at the fresh transfer cycles; (ii) human endometria may be favourable, indifferent or hostile to either fast cleaving or slow cleaving embryos depending on maternal age; and (iii) "natural' sex selection may be performed for social, psychological or medical reasons.

Adult↗
PubMed1999

Maternal risk of breast cancer and birth characteristics of offspring by time since birth.

We examined the association between birth characteristics of offspring and the subsequent maternal risk of breast cancer in a population-based cohort of 998,499 women, 13 to 48 years of age at entry. There were 9,495 incident cases of breast cancer during 12.8 million person-years of follow-up among these women. Compared with mothers of singleton infants, mothers having a multiple birth had an increased risk of breast cancer in the first 5 years after a birth (relative risk (RR) = 1.8; 95% confidence interval (CI) = 1.1-2.8). The risk for mothers having a heavy-weighted child (>3.75 kg), as compared with a child of light weight (< or =3 kg), was also slightly increased (RR = 1.2; 95% CI = 0.9-1.5). This latter effect was primarily due to an increased incidence of tumors larger than 2 cm at diagnosis (RR = 1.4; 95% CI = 0.9-1.9). Our findings are compatible with the hypothesis that the hormonal level during pregnancy influences the risk of breast cancer in the early years after delivery.

Adolescent↗
PubMed2000

[Microsurgical vasovasostomy in the age of modern reproduction medicine. A cost-benefit analysis].

WS represents the standard procedure of choice for the treatment of obstructive azoospermia following vasectomy. However, recently, ICSI has been suggested by some to represent the solution for all cases of male factor infertility regardless of its etiology based on its success rates. Therefore, we compared VVS to MESA/TESE and ICSI in terms of pregnancy, complications, and costs. Between 1/93 and 6/98 157 VVS was performed microsurgically using the 2-layer technique in 157 patients following prior vasectomy. Between 9/94 and 9/97 69 couples underwent MESA/ICSI for epididymal obstruction not amenable to micro-surgical reconstruction such as post-inflammatory obstruction and congenital absence of the vas deferens; in the same time period 42 couples underwent TESE/ICSI for azoospermia of testicular origin due to cryptorchidism, testicular atrophy, obstruction of the rete testis. In most cases MESA or TESE and ICSI were performed metachronously. Mean intervall of vasal obstruction was 7.6 (0.5-18) years; patency after VVS was 77%, pregnancy rate was 52%. Local complication rate was 4.7%, no major complications were observed. Costs per life birth after VVS were as high as 5,447,-DM or 2,800 Euro. Pregnancy rates after MESA/TESE and ICSI were 22.5% and 19.5%, respectively with 16 singletons, 3 twins and 3 abortions; local complications occurred in 3.9% of the men. Multiple birth were noticed in 15.8% following ICSI, but only in 0.7% following VVS. 5.7% and 1.4% of the female partners experienced serious complications as a mild or severe ovarian hyperstimulation-syndrome, respectively. Costs per life birth after MESA/TESE cycle were as high as 28,804,-DM or 14,100 Euro. Even in the era of ICSI microsurgical vasovasostomy represents the standard approach for obstructive azoospermia following vasectomy. Based on a cost-benefit analysis VVS is more successful in terms of pregnancy rates (52% vs. 22.5%). We conclude that MESA/ICSI should be reserved for patients not amenable for microsurgical reconstruction.

Adult↗
PubMed1999

Perinatal outcome in hospital and birth center obstetric care.

OBJECTIVE: Our purpose was to compare birth complications and fetal outcome in hospitals and birth centers. METHOD: We retrospectively compared all 801 deliveries between 1992 and 1994 from two free-standing birth centers against 3271 hospital deliveries in Berlin. The hospital collective was selected according to the same risk criteria of the birth centers. RESULTS: The birth center group had significantly fewer medical interventions, with a similar cesarean section rate (3.0% vs. 4.6%, P = 0.057) and occurrence of severe perineal lesions. The episiotomy rate was significantly higher (P < 0.001) in the clinics for first-time and multiple births. The perinatal mortality was not significantly different ( < 0.1 per 1000). One-minute Apgar scores less than 7 were found significantly more often in the birth center group. CONCLUSION: When birth centers employ thorough risk selection and significant early referral rates to nearby hospitals, there is no evidence of increased maternal or perinatal risk compared to hospital deliveries.

Birthing Centers↗
PubMed2003

The effect of birth weight discordance on twin neonatal mortality.

OBJECTIVE: To estimate the association between birth weight discordance and neonatal mortality controlling for the effects of fetal growth, and to understand the differences in the incidence of mortality between larger and smaller infants. METHODS: This analysis is based on the National Center for Health Statistics matched multiple birth data set file containing all twin births in the United States from 1995 through 1997. Birth weight discordance was grouped into four levels (15-19%, 20-24%, 25-29%, and 30% or more). Generalized estimating equations were used to obtain adjusted odds ratios and 95% confidence intervals to estimate the mortality risk associated with discordance after adjusting for fetal growth. RESULTS: Mortality was 11 times higher among highly discordant smaller twins (30% or more) compared with nondiscordant smaller twins (43.4 and 3.8 per 1000, respectively). Risk estimates ranged from 1.08 (95% confidence interval 0.85, 1.38) among 15-19% discordant twins to 2.05 (95% confidence interval 1.66, 2.51) among 30% or more discordant twins. Larger twins had similar risk estimates. After accounting for the association between fetal growth and discordance, mortality risk was substantially higher among smaller and larger twins who were highly discordant (30% or more). In addition, there was little difference in the magnitude of risk estimates between highly discordant smaller and larger twins. CONCLUSION: After controlling for fetal growth, smaller and larger twins affected by higher levels of birth weight discordance (25% or more) remain at disproportionate risk for neonatal mortality when compared with other smaller or larger twins. Additionally, smaller twins do not have an elevated risk compared with larger twins after adjusting for their different fetal growth distributions.

Birth Weight↗
PubMed2006

A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common reproductive disorder associated with many characteristic features, including hyperandrogenaemia, insulin resistance and obesity which may have significant implications for pregnancy outcomes and long-term health of the woman. This meta-analysis was conducted to evaluate the risk of pregnancy and neonatal complications in women with PCOS. Electronic databases were searched for the following MeSH headings: PCOS, hyperandrogenism, pregnancy outcome, pregnancy complications, diabetes mellitus, type II. A handsearch of human reproduction and fertility and sterility was also conducted. Studies in which pregnancy outcomes in women with PCOS were compared with controls were considered for inclusion in this meta-analysis. Fifteen of 525 identified studies were included, involving 720 women presenting with PCOS and 4505 controls. Women with PCOS demonstrated a significantly higher risk of developing gestational diabetes [odds ratio (OR) 2.94; 95% confidence interval (CI): 1.70-5.08], pregnancy-induced hypertension (OR 3.67; 95% CI: 1.98-6.81), pre-eclampsia (OR 3.47; 95% CI: 1.95-6.17) and preterm birth (OR 1.75; 95% CI: 1.16-2.62). Their babies had a significantly higher risk of admission to a neonatal intensive care unit (OR 2.31; 95% CI: 1.25-4.26) and a higher perinatal mortality (OR 3.07; 95% CI: 1.03-9.21), unrelated to multiple births. In conclusion, women with PCOS are at increased risk of pregnancy and neonatal complications. Pre-pregnancy, antenatal and intrapartum care should be aimed at reducing these risks.

Birth Weight↗
PubMed1994

Reproductive risk factors in a prospective study of breast cancer: the Nurses' Health Study.

A modification of the model of Pike et al. (Nature 1983;303: 767-70) was applied to 91,523 women in the Nurses' Health Study who did not report prevalent cancer initially and who were followed for 14 years (1,212,855 person-years and 2,341 incident breast cancers). The model took into account current age, age at all births, age at menopause, and age at menarche in predicting the annual and cumulative incidence of breast cancer. The authors found that ages both at first birth and at subsequent births have long-term influence on breast cancer incidence. The incidence density for parous women was greater than for nulliparous women for 20-30 years after the time of the first birth. However, cumulative incidence up to age 70 years was about 20% lower, 10% lower, or 5% higher for parous versus nulliparous women if their first birth was at age 20, 25, or 35 years, respectively. The authors also observed a significantly lower incidence after each additional birth as well as after menopause for women of the same age. Overall, the effect of reproductive factors (other than age at menarche) appears to influence cumulative incidence to age 70 years by a maximum of approximately 50% when women with multiple births with an early age at first birth are compared with women with a single birth at a late age.

Adult↗
PubMed1985

Size at birth in Iceland.

Anthropometric standards for weight, length and head circumference of Icelandic infants at birth are presented. The material concerning weight and crown-heel length consisted of 43 364 newborns, the total number of infants born in 1972-1981. The standards for head circumference were based on 28 978 infants born in 1975-1981. Multiple births and stillbirths were excluded from the material, leaving single livebirths with an estimated length of gestation of 28-44 weeks. No further exclusions were made. The material was compared with previous standards used in Iceland as well as with other studies of all single livebirths in geographically defined populations. Standards for crown-heel length and head circumference were compared with other studies based on more limited and selective materials. The differences between these studies emphasize the need for an international agreement on the methodology for measurement and recording of infant growth during the perinatal period.

Birth Weight↗