Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Postpartum Programs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,099 records · Page 61Linked to original sources
PubMed1997

Energy and nutrient inadequacies in the diets of low-income women who breast-feed.

OBJECTIVE: To assess the energy and nutrient intakes of women who are breast-feeding in relation to the Recommended Dietary Allowances (RDAs) for energy and nutrients during lactation. DESIGN: Survey using a interviewer-administered questionnaire and a 24 dietary recall. SUBJECTS: The subjects were 183 women breast-feeding at 3 months postpartum. All were living in low-income communities in Ontario, Canada, that were participating in the longitudinal prevention initiative, Better Beginnings, Better Futures. STATISTICAL ANALYSES: Mann-Whitney U test to compare energy and nutrient intakes of women with incomes above and below the Statistics Canada poverty line. RESULTS: Median intake of energy (2,148 kcal) was below the RDA of 2,700 kcal. Compared with the RDAs, intakes of calcium (928 vs 1,200 mg), folate (222 vs 280 microns), iron (13 vs 15 mg), thiamin (1.4 vs 1.6 mg), vitamin A (846 vs 1,300 retinol equivalents), and zinc (10 vs 19 mg) were below recommended values for women who are lactating. Although household income for 70% of the women was below the poverty line, differences in energy and nutrient intakes according to income group were not statistically significant. APPLICATIONS: Lactating women are at high risk of energy and nutrient inadequacies. Programs to increase breast-feeding rates, particularly among low-income communities, must include strategies to ensure adequate diets during lactation.

Adolescent↗
PubMed1985

Glucose monitoring and insulin administration in the pregnant diabetic patient.

Over the past decade, it has been apparent that the degree of glycemic control achieved in the pregnant patient with diabetes mellitus significantly affects perinatal outcome. While several studies have documented excellent perinatal outcome with good glucose control, the incidence of neonatal morbidity still remains substantially greater than that observed in the general population. Physiologic or "tight" control appears to further reduce the incidence of macrosomia, hypoglycemia, and other indices of neonatal morbidity. The application of home glucose-monitoring techniques to pregnancies complicated by diabetes can result in optimal glucose control. While one small comparative series did not document improvement in perinatal morbidity, fewer admissions for diabetic control and decreased patient expense were observed in the group using home monitoring. After pregnancy, most patients continued to use home monitoring. This probably reflects the degree of patient enthusiasm and interest generated by self-care. Programs using home blood glucose monitoring and individualized insulin regimens in the management of diabetes may have their greatest impact if implemented prior to conception. The degree of glucose control during early embryogenesis appears to determine the incidence of congenital malformations in the offspring of insulin-dependent diabetic women. Continued careful assessment of the degree of glycemic control may enable the patient and her physician to plan the optimal time for attempting a pregnancy.

Blood Glucose↗
PubMed1984

Postpartum performance in a diallel cross among lines of mice selected for litter size and body weight.

Postpartum dam performance was studied in a complete diallel design involving five lines of mice. The selection criterion in each line was: large litter size at birth (L+); large 6-wk body weight (W+); an index for large litter size and small 6-wk body weight (L+W-); the complementary index (L-W+) and random (K). Females from the five lines and 20 reciprocal F1 crosses were mated to sires of a randomly selected control line (CC). Correlated responses in average direct genetic and average maternal genetic effects for dam body weight and litter size at parturition persisted throughout lactation, indicating important pleiotropic effects. Major correlated responses occurred for litter weight, feed intake and litter feed efficiency, primarily due to average direct genetic effects. Using general combining ability and net line effects as criteria for choosing among lines, L+ had a distinct advantage if the objective was to increase litter size in a crossing program. If the objective was to maximize litter weaning weight, then W+ would be favored for net line effects, while L+ and W+ would be about equivalent for general combining ability. None of the lines had an advantage for litter feed efficiency. Direct heterosis for dam weight at 12 and 21 d of lactation averaged 2.7 and 1.9%, while for litter size the respective averages were 7.4 and 7.3%. The W+ X L+W- cross exhibited overdominance for litter size. Direct heterosis was moderate for feed intake and litter weight, but was negligible for litter feed efficiency because of the mathematical relationship among the three traits. Maternal heterosis for preweaning progeny growth was suppressed because of heterosis for litter size in the dam. Grand-maternal effects on growth of the young were small and would not be an important consideration in choosing among these lines in a crossbreeding program.

Animals↗
PubMed1984

Changes throughout estrous cycles of variables that might indicate estrus in dairy cows.

Two experiments examined physiological changes throughout estrous cycles of Holstein cows. In experiment one, changes were characterized for physical activity, vaginal pH, vaginal temperature, milk yield, heart rate, and concentration in blood plasma of progesterone and 13,14-dihydro-15-keto-prostaglandin F2 alpha. Variables were measured daily in 11 cows through a total of 28 estrous cycles. Cows in estrus at least once postpartum were used. Observations for estrus were at least twice daily. Variables changed significantly with day of estrous cycle. Changes of progesterone, physical activity, and 13,14-dihydro-15-keto-prostaglandin F2 alpha were more marked around estrus than were changes of the other variables. Peaks of physical activity coincided with estrus in 75% of the cases. Experiment two was to determine if increased physical activity, measured with pedometers, coincided with estrus in commercial dairy herds. Cows on 14 farms in New York were fitted with mechanical pedometers, and the pedometers were read at each milking. Readings from 3 days before until 3 days after estrus were used from 55 estrous periods identified by the producers. Physical activity was maximal on day of estrus in 73% of the estrous periods. Increased physical activity of commercial dairy cows agreed well with the producers' diagnoses of estrus. Pedometers could be a valuable component of an estrous detection program.

Animals↗
PubMed1989

Breast-feeding intentions and practice among Hispanic mothers in southern California.

Breast-feeding intentions, breast-feeding in the hospital, and breast-feeding at home were studied among 132 Hispanic mothers participating in the Expanded Food and Nutrition Education Program in southern California. There was not a large difference between total breast-feeding intention (77.7%) and total breast-feeding practice (63.8%). However, the 67.7% intention of exclusive breast-feeding drastically decreased to 19.7% and 17.2% in the hospital and at home, respectively. Formula supplementation, increased by 4.5 times from intention to practice. Exclusive formula feeding increased from 10.0% to approximately 37.0% in the hospital and at home. Stepwise logistic regression identified that the likelihood of intending breast-feeding was greater for mothers who migrated from Mexico than for mothers born in the United States (odds ratio 4.75). The likelihood of breast-feeding practice was greater for mothers who initiated breast-feeding within the first 10 hours after birth as opposed to 11 or more hours (odds ratio 1.27), for mothers who had a vaginal rather than cesarean delivery (odds ratio 12.76), for mothers who did not return to work postpartum as opposed to working mothers (odds ratio 28.26), and for mothers who migrated from Mexico compared with mothers born in the United States (odds ratio 8.54). The importance of assessing and supporting mothers' breast-feeding intentions in the pre- and post-partum period is documented. Training in the clinical aspects of breast-feeding and improvement of hospital protocols is recommended. Mothers intending to breast-feed should be identified and supported.

Adult↗
PubMed1994

Ethnicity and the use of health services in Belize.

Data from the 1991 Belize Family Health Survey show differentials in the use of maternal and child health services between ethnic groups (Creole, Mestizo, Maya/Ketchi and Garifuna). Multivariate analysis is used to explore whether such differentials can truly be attributed to ethnicity or to other characteristics that distinguish the ethnic groups. Health services considered are: family planning, place of delivery (hospital/other), postpartum and newborn check-ups after a birth, and immunisations for children. The language usually spoken in the household is found to be important for interpreting ethnic differentials. Mayan-speaking Maya/Ketchis are significantly less likely to use family planning services or to give birth in a hospital. Spanish-speakers (Mestizos and Maya/Ketchis) are less likely to use newborn and postpartum check-ups, after controlling for other characteristics. There are no ethnic differentials for immunisations. Programmatic implications of these results are discussed.

Adolescent↗
PubMed1996

Factor V Leiden: should we screen oral contraceptive users and pregnant women?

The factor V Leiden mutation is the most common genetic risk factor for deep vein thrombosis: it is present in about 5% of the white population. The risk of deep vein thrombosis among women who use oral contraceptives is greatly increased by the presence of the mutation. The same seems to be true of the risk of postpartum thrombosis. Several authors have called for all women to be screened before prescription of oral contraceptives and during pregnancy. Such a policy might deny effective contraception to a substantial number of women while preventing only a small number of deaths due to pulmonary emboli. Moreover, in pregnancy the ensuing use of oral anticoagulation prophylaxis might carry a penalty of fatal bleeding that is equal to or exceeds the risk of death due to postpartum thrombosis. It might pay, however, to take a personal and family history of deep vein thrombosis when prescribing oral contraceptives or at a first antenatal visit to detect women from families with a tendency to multiple thrombosis.

Contraceptives, Oral↗
PubMed2006

Comparison of two estrus-synchronization protocols and timed artificial insemination in dairy cattle.

The objective of this study was to evaluate the effect of the Ovsynch protocol with and without exogenous progesterone on pregnancy rate (PR) in cows in which estrous cycles were previously synchronized with 2 doses of PGF(2alpha) and that were not detected in estrus during the presynchronization period. The study was conducted in Chihuahua, Mexico (8,650 Holstein milking cows; 305-d mature equivalent milk yield = 13,790 kg). On d 47 postpartum, estrous cycles in cows were synchronized by using 2 doses of PGF(2alpha) 14 d apart. Any cow detected in estrus during this presynchronization period was inseminated. Cows not detected in estrus were selected at random and assigned to receive progesterone supplementation or to serve as controls. Controls (n = 594) were subjected to the Ovsynch protocol and cows in the progesterone supplemented treatment (n = 594) were subjected to the Ovsynch protocol plus an intravaginal insert containing 1.9 g of progesterone inserted at the time of the first GnRH injection and removed 7 d later. Progesterone-supplemented cows had a greater PR (31.2%) compared with controls (22.7%). Plasma progesterone concentrations at artificial insemination (AI) were <1 ng/mL and did not differ between treatments. At 14 d post-AI, however, more cows that received progesterone supplementation had concentrations of progesterone >1 ng/mL compared with controls. It was concluded that after a presynchronization period, cows subjected to the Ovsynch program and supplemented with exogenous progesterone had a greater PR and greater concentrations of progesterone after AI than those subjected to the Ovsynch protocol and not supplemented with progesterone.

Animals↗
PubMed2003

Regulation of the resistance to nematode parasites of single- and twin-bearing Merino ewes through nutrition and genetic selection.

Periparturient Merino ewes obtained from lines of sheep that had been selected either for increased resistance to Haemonchus contortus (R) or at random (C) were supplemented, while grazing at pasture, with either nil or 250 g/day cottonseed meal (CSM) for the 6 weeks prior to or the 6 weeks after the start of parturition. Ewes from both supplement groups had lower (mean 66% reduction) faecal egg counts (FECs) during the postpartum period and this coincided with a period of maternal body weight loss. Factors which increased the rate of maternal body weight loss, such as pregnancy and lactation status, also increased FEC. Evidence is presented that the magnitude of the periparturient rise (PPR) in FEC in grazing ewes will be greatest during periods of maternal weight loss and at these times supplementation to increase metabolisable protein (MP) supply will be most effective in increasing resistance to nematode parasites. The resistance of R ewes to nematode parasites was greater than that of C ewes throughout the experiment and was sufficiently low such that anthelmintic treatment in a commercial environment may not have been required. Irrespective of actual FEC, ewes from all treatment combinations exhibited a PPR in FEC. Reduced FEC of R ewes resulted in reduced apparent pasture larval contamination after 18 weeks of continuous grazing but supplementation was ineffective in this regard. It is suggested that integrated parasite management (IPM) programs for periparturient ewes should make use of both protein supplementation and genetic selection to increase worm resistance and reduce dependency on anthelmintics for worm control.

Animal Nutritional Physiological Phenomena↗
PubMed2003

Sulfadiazine and pyrimethamine in the postnatal treatment of congenital toxoplasmosis: what are the options?

Pre- and neonatal screening for congenital toxoplasmosis rests upon the assumption that treatment is beneficial on either acute symptoms or in preventing later reactivation. Postpartum treatment of congenital toxoplasmosis with sulfadiazine and pyrimethamine has remained almost unchanged for 50 years. More recently, sulfadiazine has been substituted by sulfadoxine, which has a much longer half-life and provides a basis for a dose schedule with higher compliance. Newer drugs with potential effects against Toxoplasma gondii, such as azithromycin, atovaquone and clindamycin, require further evaluation in animal models and human studies. No randomized controlled trials have ever been conducted. The available studies are either observational studies of groups of referred patients or observational studies with historical controls accrued over many years, often decades. Pre- and neonatal screening for congenital toxoplasmosis is performed on more than two million pregnant women every year in Europe, North and South America at the estimated cost of more than 500 million annually. The benefit needs to be documented by a prospective, placebo-controlled randomized study, which needs to be organized and financed by the countries performing nationwide, universal screening programs.

Humans↗
PubMedDate not supplied

Use of contraceptives for birth spacing in a Nigerian city.

This paper examines the use of contraceptives among women aged 15-35 in the urban area of Ilorin, Nigeria, with particular focus on use for the purpose of spacing births. Approximately 19 percent of ever-married women in the sample had used contraceptives at some time and approximately 6 percent were using at the time of the survey. Results suggest that some women have used or are using contraceptives as a substitute for prolonged periods of postpartum sexual abstinence. Whereas all groups of women in the study prefer to maintain an interval of two years between births, less traditional women no longer prefer to observe long periods of postpartum sexual abstinence. For some women, therefore, there is a wide gap between the length of preferred birth interval and the length of preferred abstinence. The magnitude of this gap is significantly associated with both ever use and current use of contraceptives. Other variables found to have a significant independent effect on contraceptive use were total number of children desired, maternal age, and maternal education.

Adolescent↗
PubMed1989

The social epidemiology of smoking during pregnancy among Mexican women.

The association between maternal tobacco smoke exposure and hazards to reproduction has been investigated since the turn of the century. Numerous studies have demonstrated an increased risk to the developing fetus as a result of maternal smoking. This risk continues to manifest itself postnatally into childhood. The present study examined both risk factors for and consequences of smoking behavior among a sample of 50 pregnant women consecutively admitted to the obstetrics ward of the Tijuana General Hospital, Tijuana, Mexico. A questionnaire completed postpartum examined social, cultural, and economic variables for the mother, and physical variables of the newborn. Twenty-one subjects were smokers and 29 were nonsmokers. The number of previous pregnancies per subject was significantly higher in the group of smoking mothers. Overall, 86.2% of the nonsmoking mothers had three or fewer pregnancies versus 52.4% of the smoking mothers (p less than or equal to 0.005). It was also noted that the smoking subjects tended to be light smokers (90% reported smoking ten or fewer cigarettes a day, with an average of 4.27 years of smoking history). No difference in knowledge of the harmful effects of smoking during pregnancy was observed between the two groups; however, the proportion of subjects whose mothers and siblings also smoked was significantly higher (p less than or equal to 0.005 and p less than or equal to 0.01, respectively) in the smoking groups. The results are discussed in terms of antismoking prevention and health promotion programs for the developing world.

Adult↗
PubMed1991

Physiological and perceptual responses to cycle and treadmill exercise during pregnancy.

We compared physiological and perceptual responses to non-weight bearing (cycle) and weight bearing (treadmill) exercise in 16 sedentary women throughout a normal term pregnancy. Subjects were recruited late in the first trimester (less than 13 wk gestation) and were studied at 4 wk intervals throughout pregnancy and 4 wk postpartum (PP). Exercise consisted of four 5 min protocols; two were performed on the cycle (C1 = 50 W; C2 = 75 W) and two on the treadmill (T1 = 66 m.min-1, 2.5% grade; T2 = 66 m.min-1, 12% grade). Measured variables included oxygen consumption (VO2), heart rate (HR), minute ventilation (VE), and ratings of perceived exertion (RPE, 10-point Borg scale). Absolute VO2 (ml.min-1) during cycle exercise increased (P less than 0.001) by 25 wk gestation, while relative VO2 (ml.kg-1.min-1) during treadmill walking was unchanged through late pregnancy and PP. This suggests that cycle exercise is not a true non-weight bearing exercise within a given group of women throughout gestation. Subjects' VO2max values were estimated at each test interval and found to increase (P less than 0.001) by 25-28 wk gestation. Heart rate and RPE responses to exercise remained constant throughout gestation and decreased (P less than 0.01) PP. Although they did not participate in a regular exercise program, it appears that our subjects experienced a mild aerobic training effect during late pregnancy.

Adult↗
PubMed1998

A veterinary perspective of on-farm evaluation of nutrition and reproduction.

Reproductive herd health programs of the 1960s and 1970s focused primarily on the control of infectious and noninfectious diseases of the reproductive tract, estrus detection, breeding technique, semen quality and handling, and endocrine imbalances. Despite veterinary intervention, conception rates dropped from 55% before this period to 45% after this period, but milk production increased greatly. Because studies have shown that the additional nutritional needs for high producing cows may be a factor limiting reproduction, bovine practitioners have become more involved with dairy nutrition. New emphasis has been placed on the concept of total production medicine with the anticipation that improved nutrition would improve reproduction. Because of a better understanding of the dynamics of energy in the dairy cow and its effect on reproduction, fertility examinations now include nutrition monitoring and body condition scoring. Several relationships between nutrition and fertility have been identified: high producing thin cows that drop 0.75 to 1.0 in body condition score resulting in anestrus; fat dry cows that develop fatty livers and associated postpartum disease; heifers that have good milk production but prolonged anestrus; dry cows with ration imbalances during the transition period that develop milk fever, retained placenta, displaced abomasum, metritis, or endometritis; lactating cows with disease in midlactation, especially feet and leg problems, resulting in lowered fertility; and healthy, lactating cows with poor conception that have high concentrations of urea N in blood or milk.

Animal Nutritional Physiological Phenomena↗
PubMed2005

Neonatal phenobarbital imprints overexpression of cytochromes P450 with associated increase in tumorigenesis and reduced life span.

Perinatal exposure to phenobarbital produces a range of permanent reproductive, growth, locomoter, and learning dysfunctions in animals as well as humans. In addition, the affected individuals exhibit latently expressed (i.e., postpubertal) above normal activity levels of hepatic multicytochrome P450-dependent drug metabolizing enzymes. We report that in spite of apparent normal health for the better part of their lives, daily administration of therapeutic-like doses of phenobarbital to male and female rat pups during the first postpartum week reduced life expectancy by approximately 20%. Necropsy at the time of natural death revealed an associated two- to threefold increase in the incidence of tumors in barbiturate-exposed rats of both sexes and a three- to fourfold increase in urinary tract pathologies in male rats. At 2 yr of age, in agreement with an overexpression of hepatic CYP2C6 and CYP2C7, both in vitro and in vivo drug metabolism was more rapid in the phenobarbital-imprinted male and female animals. Moreover, when the senescent rats were rechallenged with a nominal dose of the barbiturate, males and females neonatally exposed to phenobarbital exhibited a dramatic overinduction of multicytochrome P450-dependent drug metabolizing enzymes as well as an overexpression of individual isoforms of cytochrome P450 implicated in enhanced susceptibility to tumorigenesis. Our findings support the growing realization that many adult diseases have their origins in early life by emphasizing that unlike adults, the new born is "plastic," and even therapeutic drugs may produce "silent" programming defects that subtly, but irrevocably, jeopardize life-long well-being.

Animals↗
PubMed1995

[Autologous blood donation in obstetrics].

OBJECTIVE: To demonstrate the safety of autologous blood donation in an obstetric practice. METHODS: A total of 2350 pregnant patients were screened for an increased risk of peripartum bleeding. Excluding patients with contraindications, a total of 71 women participated in this autologous blood donation program. Blood was donated in the 35th and 37th weeks of pregnancy. RESULTS: No problems occurred in the course of blood donation. All newborns were found to be healthy; 41 of the 71 patients received peripartum autologous blood transfusions. Homologous blood was not given to any of the patients. CONCLUSION: Our experience demonstrates that autologous blood donation is a safe practice in the setting of obstetrics, when the indications and contraindications are considered. Further studies in larger patient populations are necessary to expand or restrict the indications for autologous transfusion in obstetrics.

Adult↗
PubMedDate not supplied

Maternal mortality in rural Bangladesh: the Jamalpur District.

During the 12-month period from September 1982 to August 1983, 9,317 live births and 58 maternal deaths were recorded in Melanda and Islampur upazilas in the Jamalpur district of rural Bangladesh, giving a maternal mortality rate of 62.3 per 10,000 live births. Maternal mortality was positively related to maternal age and parity, with the mortality risk rising very sharply beyond age 35 years, and beyond parity four among women aged 25-34 years in particular. The most common causes of maternal death were eclampsia (20.7 percent), septic abortion (20.7 percent), postpartum sepsis (10.3 percent), obstructed labor (10.3 percent), and antepartum and postpartum hemorrhage (10.3 percent). These findings indicate that family planning, by decreasing the likelihood of pregnancy after age 35 and parity four, can help reduce the proportion of women at risk of maternal mortality.

Adolescent↗
PubMedDate not supplied

Teaching family-centered perinatal care in family medicine, Part I.

Pregnancy, childbirth, postpartum, and infant care are a continuum in the family life cycle for which the family physician is especially qualified to provide primary, comprehensive care. The purpose of this paper is to document and share the controversies, wisdom, and knowledge about caring for women and their families before, during, and after pregnancy. Family physicians can be leaders in developing an appropriate perinatal care system for the community. The level of care the family physician chooses to provide is discretionary. However, the family physician should be invested in ensuring that all families receive the greatest benefit from pregnancy, birth, and the newborn experience. Interest in perinatal care in family medicine is increasing, as reflected by the growing numbers participating in the Society of Teachers of Family Medicine Working Group on Family-Centered Perinatal Care. The authors of this article, who are active in this working group, hope that this information is useful in designing a balanced curriculum and delivery system for perinatal care in family medicine training programs.

Curriculum↗