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PubMed2000

Delivery of breech first twins: a multicenter retrospective study.

OBJECTIVE: To assess the risk of vaginal birth of breech first twins by Apgar scores and mortality. METHODS: We did a retrospective case-control analysis of data from 13 centers that allow vaginal birth for breech first twins. We used depressed 5-minute Apgar scores and neonatal mortality as main outcome measures between vaginal (n = 239) and cesarean (n = 374) deliveries of pairs with breech first twins, stratified by parity, birth weights of first twins, and types of cesarean. The 95% power of our sample size (alpha = .05) was sensitive enough to detect differences of 5% of the overall sample and 25-30% of subgroups. RESULTS: Vaginal birth was attempted in 61% of 613 pairs. There were significantly more depressed Apgar scores (P = .008, odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2, 4.7) and neonatal deaths (P < .001, OR 9.5, 95% CI 4.0, 23.4) among vaginal births of pairs in whom first twins weighed less than 1500 g but not among the higher-birth-weight cohort (for depressed Apgar scores: P = .76, OR 1.1, 95% CI 0.6, 2.1). Multiparity and elective cesarean seemed to have little influence on outcome measures. Neonatal mortality was associated with extremely preterm twins. CONCLUSION: There was no evidence that vaginal birth is unsafe, in terms of depressed Apgar scores and neonatal mortality, for breech first twins that weighed at least 1500 g.

Apgar Score↗
PubMed2006

Effects of housing, management, and health of dairy heifers on first-lactation udder health in southwest Sweden.

Data on health, management, and housing from birth to first calving were collected for 2,126 heifers on semi-monthly visits made by project veterinarians to 107 dairy herds from southwest Sweden. Additional data were obtained from the official milk- and health-recording program. Factors associated with incidence of veterinarian-treated clinical mastitis (VTCM) in the period 7 d before (d -7) to 30 d after first calving and of elevated cow composite somatic cell count (SCC, > or =200,000 cells/mL) at first test milking after first calving, respectively, were investigated using a 2-level (animal and herd) logistic regression analysis after initial screening by univariate analyses. The incidence risk of VTCM during the complete first lactation (305 d) was 10.8%. Ten percent of the diseased animals had more than 1 case of VTCM and 51% of total cases occurred from -7 to 30 d postcalving. The incidence rate of VTCM during the complete first 305-d lactation was 1.13 cases per 100 cow-mo. In total, 18.1% of the animals had elevated SCC at first test milking (mean 21 d) after calving. Veterinarian-treated clinical mastitis at -7 to 30 d postcalving was associated with higher overall incidence of mastitis in the herd and with reproductive disorders (i.e., retained placenta, endometritis, pyometra, dystocia, or twin birth). The risk of elevated SCC increased with increasing percentage of cows in the herd that, some time during the year, had had an increased udder disease score (chronically increased SCC). Other factors associated with increased risk of elevated SCC were increasing amounts of concentrates fed to 11- to 16-mo-old heifers, moving to confined housing the day of calving instead of earlier, and use of restraint measures at milking. In addition, growth rate from birth to weaning, and several feed-related variables (e.g., amount of concentrates and type of roughage given) were associated with VTCM at -7 to 30 d post-calving or elevated SCC at first test milking in the univariate analyses.

Animals↗
PubMed2004

Childbearing and the risk of scleroderma: a population-based study in Sweden.

This study examined associations between childbearing and risk of scleroderma by using national population-based registry data from Sweden. Women with a discharge diagnosis of scleroderma from 1964 to 1999 (n = 2,149) were identified in the Swedish Inpatient Register. These cases were matched by year and month of birth and region of residence to as many as five controls obtained from the Multi-Generation Register. Pregnancy history (number of births, age at each birth) was restricted to births before the first scleroderma-related hospitalization for cases and the corresponding age for their matched controls. Risk estimates, measured by the odds ratio and 95% confidence interval, were obtained by using conditional logistic regression. Nulliparity was associated with an increased risk of scleroderma (odds ratio = 1.37, 95% confidence interval: 1.22, 1.55). Risk decreased with increasing number of births. Similar results were found when analyses were limited to births up to 2 years or up to 5 years before hospitalization. Among parous women, younger age at first birth was associated with an increased risk of scleroderma. The association between lower parity and increased risk of scleroderma could reflect subfecundity caused by scleroderma before disease became clinically evident, possible common causes of infertility and scleroderma, or a protective effect of pregnancy through an unknown mechanism.

Adolescent↗
PubMed1994

Time of the first defaecation and urination in very low birth weight infants.

The time for passage of the first stool and urine was studied in 111 infants who weighed less than 1500 g at birth. Delayed passage of the first stool (greater than 24 h) was noted in 25 (22.5%) infants of this group, including 7 cases (6.3%) in whom the delay was greater than 48 h (4 on the 3rd day, 2 on the 4th day, 1 on the 6th day of life, respectively). Three (2.7%) cases had delayed passage of the first urine (at 25, 25, and 45 h of life, respectively). Significant differences between the two groups with delayed and nondelayed passage of the first stool were noted in both the gestational age and in the time of the first enteral feeding. In very low birth weight infants, delay in the passage of the first stool is a common occurrence. This delay is probably due to physiological immaturity of the motor mechanisms of the gut, and lack of triggering effect of enteral feeds on gut hormones. As far as passage of the first urine was concerned, there were no significant perinatal factors found between the delayed and nondelayed groups.

Defecation↗
PubMed1988

Factors affecting dystocia and birth weight in Grati cattle in Pujon, East Java.

This paper discusses factors affecting dystocia and birth weight in Grati cattle in three villages in the Pujon district, East Java. Records of birth weight, dystocia score, village, season, parity, sex, artificial versus natural service, and age and weight of dam, were obtained from 268 parturitions. Village and weight of the dam had a significant effect on birth weight but not on dystocia. Parity had a significant effect on dystocia score. More abnormal births occurred with AI using exotic bulls. Calves from an abnormal birth were on average more than three kg heavier. First parity births combined with Al with exotic bulls had a particularly high incidence of dystocia. It is concluded that farmers in Pujon can reduce the incidence of dystocia in heifers by using local bulls only.

Animals↗
PubMed1989

Projecting individualized probabilities of developing breast cancer for white females who are being examined annually.

To assist in medical counseling, we present a method to estimate the chance that a woman with given age and risk factors will develop breast cancer over a specified interval. The risk factors used were age at menarche, age at first live birth, number of previous biopsies, and number of first-degree relatives with breast cancer. A model of relative risks for various combinations of these factors was developed from case-control data from the Breast Cancer Detection Demonstration Project (BCDDP). The model allowed for the fact that relative risks associated with previous breast biopsies were smaller for women aged 50 or more than for younger women. Thus, the proportional hazards models for those under age 50 and for those of age 50 or more. The baseline age-specific hazard rate, which is the rate for a patient without identified risk factors, is computed as the product of the observed age-specific composite hazard rate times the quantity 1 minus the attributable risk. We calculated individualized breast cancer probabilities from information on relative risks and the baseline hazard rate. These calculations take competing risks and the interval of risk into account. Our data were derived from women who participated in the BCDDP and who tended to return for periodic examinations. For this reason, the risk projections given are probably most reliable for counseling women who plan to be examined about once a year.

Adult↗
PubMed1990

Preparation for caesarean childbirth: derivation of a nursing intervention from the Roy Adaptation Model.

The paper describes a programme of research directed toward developing and testing a nursing intervention derived from the Roy Adaptation Model of Nursing and designed to prepare expectant parents for unplanned Caesarean birth. The first study was a retrospective survey of Caesarean-birth parents that revealed the need for detailed information about the events surrounding Caesarean birth. The second study was a clinical field test of the nursing intervention, which consisted of a pamphlet containing information about all aspects of Caesarean birth with follow-up discussion of pamphlet content. Data analysis indicated that Caesarean-birth parents found the pamphlet content informative and reassuring and found the follow-up beneficial. The third study was a clinical field test of a modified version of the intervention consisting of the pamphlet and focused discussion about Caesarean birth. Data analysis revealed that the nursing intervention provided the information expectant parents needed to prepare for the possibility of Caesarean childbirth. The fourth study is an ongoing experiment designed to test the effects of the nursing intervention on responses to unplanned Caesarean birth. Emphasis throughout the paper is placed on the links between the Roy Adaptation Model and the methodology and findings of each study.

Adaptation, Psychological↗
PubMed1980

Analysis of messenger RNA coding for S100 protein in the mammalian brain.

S100 protein is a brain-specific protein which is absent at birth and first appears in rabbit brain 2-3 days after birth. To determine how the synthesis of this brain-specific protein is regulated, mRNA was isolated from brain polysomes and assayed for S100 protein mRNA activity by in vitro translation in a heterologous cell-free system and immunoprecipitation of released polypeptides with rabbit anti-S100 protein antiserum. S100 protein mRNA was detected primarily in small polysomes containing five to eight ribosomes, and virtually no S100 protein mRNA was present in polysomes containing more than eight ribosomes. S100 protein mRNA was not detected in brain polysomes at stages prior to the induction of synthesis of S100 protein, i.e., in fetal brain or in 1-day neonates. The amount of S100 protein mRNA in polysomes of the cerebral cortex and cerebellum was measured to see if it correlated with the level of S100 protein in the two regions of adult brain. The cerebellum, which contained three to four times the level of S100 protein in the cerebral cortex, contained four times more S100 protein mRNA.

Aging↗
PubMed1988

Blood pressure measurements in very low birth weight infants over the first week of life.

Intra-arterial blood pressure measurements recorded during the first week of life in 32 stable very low birth weight infants (20 of birth weight up to 1250 g and 12 with birth weight 1251-1500 g) were reviewed. None of the infants received inotropic drugs or were given infusions of colloids to manipulate the blood pressure during the periods from which the recordings were taken. The mean systolic, mean and diastolic blood pressure measurements for infants of birth weight greater than 1250 g were significantly higher than those recorded in the infants of birth weight of up to 1250 g (figure 1). The mean blood pressure (calculated by adding one third of the pulse pressure to the diastolic pressure) in the larger infants showed a significant increase with increasing postnatal age, but this increase was not apparent in the smaller infants (figure 2). Figure 3 shows the range of systolic, mean and diastolic blood pressure values that were recorded. The mean values were remarkably constant with diastolic blood pressure varying between 31 and 34 mmHg, mean blood pressure between 35 mmHg and 40 mmHg, and systolic blood pressure between 46 mmHg and 52 mmHg. Intra-arterial lines provide a convenient and accurate route for blood pressure monitoring. It is important that a normal range of blood pressure values in the very low birth weight infant is established so that hypotension, with the potential risk of cerebral ischemia, can be avoided.

Blood Pressure↗
PubMed1983

Germ cell development in female pouch young of the tammar wallaby (Macropus eugenii).

The cytology, timing, numbers and arrangement of germ cells in gonads of 35 female tammar wallaby pouch young aged from newborn to 210 days post partum were determined from serial sections. Germ cell cytology was essentially similar to that in eutherians. The total number of germ cells per ovary reached a peak of about 4.5 X 10(5) at 50 days and was reduced to about 25% of the maximum value by 210 days. The first oogonia developed from primordial germ cells soon after birth; the first meiotic oocytes were formed between 24 and 30 days; follicularization of diplotene oocytes began at about 50 days, and by 210 days normal, prefollicular germ cell development had ended. Successive stages of germ cells were initiated at the inner margin of the cortical region of the gonad and spread as a series of waves to the tunica albuginea. At all stages of oogonial and oocyte development many cells showed characteristic degenerative changes leading to atresia. The timing of female germ cell development in relation to gestation in tammars and humans is comparable if tammar gestation is taken to include pouch life.

Aging↗
PubMed1985

Effects of birth order and maternal age on infant and child mortality in rural Nepal.

"The present study examines the effects of woman's age at childbirth (maternal age) and birth order on infant and child mortality in rural Nepal." Data are from the Nepal Fertility Survey of 1976, carried out as part of the World Fertility Survey. The results show that the risk of infant death is higher for extreme birth orders. "The higher risk of infant death to first order births is mainly due to the fact that such births occur predominantly to young women. The importance of the synergistic effect of maternal age and birth order is also demonstrated: for example, fifth order births to women aged 20-24 and third order births to women under 20 have a risk of about one infant death in every four live births."

Age Factors↗
PubMed2002

Long-term trends in sunshine duration and its association with schizophrenia birth rates and age at first registration--data from Australia and the Netherlands.

BACKGROUND: Based on the well-described excess of schizophrenia births in winter and spring, we hypothesised that individuals with schizophrenia (a) would be more likely to be born during periods of decreased perinatal sunshine, and (b) those born during periods of less sunshine would have an earlier age of first registration. METHODS: We undertook an ecological analysis of long-term trends in perinatal sunshine duration and schizophrenia birth rates based on two mental health registers (Queensland, Australia n=6630; The Netherlands n=24,474). For each of the 480 months between 1931 and 1970, the agreement between slopes of the trends in psychosis and long-term sunshine duration series were assessed. Age at first registration was assessed by quartiles of long-term trends in perinatal sunshine duration. Males and females were assessed separately. RESULTS: Both the Dutch and Australian data showed a statistically significant association between falling long-term trends in sunshine duration around the time of birth and rising schizophrenia birth rates for males only. In both the Dutch and Australian data there were significant associations between earlier age of first registration and reduced long-term trends in sunshine duration around the time of birth for both males and females. CONCLUSIONS: A measure of long-term trends in perinatal sunshine duration was associated with two epidemiological features of schizophrenia in two separate data sets. Exposures related to sunshine duration warrant further consideration in schizophrenia research.

Adolescent↗
PubMed1997

Childbearing and mortality from cancer of the corpus uteri.

BACKGROUND: To investigate the mortality from cancer of the corpus uteri in relation to parity and age at first and last birth. METHODS: A cohort of 431,604 married women aged 45-74 years at the Norwegian Census in 1970 was followed over 15 years. A total of 752 deaths from cancer of the corpus uteri were diagnosed during follow-up. RESULTS: All age groups showed significant trends of decreasing mortality rates with increasing number of children. The age-adjusted reduction in mortality was 9.2% (95% CI 5.2-13.0) for each child. Women with 8-11 children had a relative risk of 0.35 (95% CI 0.14-0.85) compared to nulliparous women. For first birth at age > = 35 years versus < = 19 years, the relative risk was 0.53 (95% CI 0.34-0.83). No significant effect of age at last birth was found. CONCLUSIONS: This study supports the notion that high parity and postponing the first delivery may reduce the risk of uterine cancer death.

Age Factors↗
PubMed2001

Rates of preterm delivery among Black women and White women in the United States over two decades: an age-period-cohort analysis.

The authors assessed the influence of age, period, and cohort effects on rates of preterm delivery in the United States. Rates of preterm delivery for singleton births (<37 weeks) in seven age groups (15-19, 20-24,., 45-49 years), five periods (1975, 1980, 1985, 1990, 1995), and 11 maternal birth cohorts (1926-1930, 1931-1935,., 1976-1980) were examined. Over the 20-year study interval, preterm delivery increased by 3.6% among Blacks (from 15.5% in 1975 to 16.0% in 1995) and by 22.3% among Whites (from 6.9% to 8.4%). Among Black primigravid women, rates of preterm delivery increased from 1975 to 1990 and began to decline thereafter; among Whites, the rates increased between 1975 and 1995. In Blacks, women aged 25-29 years had the lowest rates for the first and second births, and women aged 30-34 years had the lowest rate for subsequent births. In Whites, the age groups with the lowest preterm delivery rates were 20-24 years for first births and 25-29 years for subsequent births. Cohort-specific rates of preterm delivery remained fairly constant across age strata and periods for Whites, but a small trend was apparent for Blacks aged 30-44 years. The consistency of the observed age effects across periods and cohorts suggests that the age effect is partly due to biologic factors. The presence of period effects might be linked to the increased survival of premature infants or to increased viability among births occurring at lower lengths of gestation.

Adolescent↗
PubMed1984

[How consistent are personal data? Analysis of statements on the planning status of pregnancies].

The consistency of responses on the planning status of births is analyzed using data from a longitudinal fertility survey being carried out by the Demographic Institute of the Austrian Academy of Sciences. Interviews were conducted in 1978 and 1981 with a sample of two marriage cohorts; in both sets of interviews a question was asked concerning the reaction to a pregnancy at the time the woman heard about it. "After linking the data for the pregnancies leading to first or second births, a consistency index suggested by Ryder and Westoff...was applied which distinguishes between random and nonrandom consistency. For the first births a proportion of 54.4% identical answers yields a consistency index of 38.0...; for second births a proportion of 53.7% identical answers results in [a] consistency index of 30.1...." Differential consistency is also analyzed according to selected socioeconomic and demographic variables as well as a variable measuring the correspondence of husband's and wife's desired family sizes in the opinion of the husband. (summary in ENG)

Attitude↗
PubMed1988

Analysis of lymphocyte proliferative response subpopulations in very low birth weight infants and during the first 8 weeks of life.

Cell-mediated immunity is not well characterized in very low birth weight infants, and abnormalities may represent a significant vulnerability to infection. This report describes 165 serial studies in 58 infants between 700 and 1300 g birth weight during the first 8 wk of life. Two ml of blood were drawn at 2-wk intervals to measure T cell numbers and subsets and response to phytohemagglutinin (PHA). Overall, lymphocyte proliferation to PHA averaged 17,264 cpm, significantly less than the adult control (23,566 cpm). T cell numbers and subsets were CD3 62% (adult controls 75%), CD4 45% (49%), and CD8 18.6% (27%). Values at birth were lower as all parameters increased for at least the first 4 wk of life: PHA at birth was 15,464 cpm, CD3 48%, CD4 37%, and CD8 13%. Because of the lymphocytosis of premature infants, the absolute numbers of total T cells and subsets were within the normal adult range despite less than 50% of the mononuclear cells at birth being T cells. A study of five infants demonstrated an average of 52% B7+ cells at birth showing that the number of B cells at birth was increased approximately 10-fold over the control number in adults. Clinical correlation showed that the increases in both the % CD8 and the absolute number of CD8+ lymphocytes after birth were correlated with both the occurrence of sepsis and the assessed lymphocyte subsets in a sizeable number of very low birth weight infants serially during the first 8 wk of life including lymphocyte function using isolated mononuclear cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

Renal functions of low birth weight infants during the first two months of life.

A postnatal contraction of extracellular fluid occurs in low birth weight infants. Patterns of postnatal renal maturation were assessed with the assumption that changes in body composition were mediated in part by the developing kidney. Twenty-two appropriate for gestational age, low birth weight infants (birth weight mean = 1380 g, gestational age mean 31 weeks) were studied between 12 hr and 61 days of age to evaluate simultaneously glomerular and tubular functional maturation. Since most low birth weight infants have respiratory morbidities (respiratory distress followed by chronic lung disease), the infants were grouped into: group I (13 infants), transient or absent respiratory morbidities; and group II (9 infants), persistent and severe respiratory morbidites. Sodium excretion decreased with postnatal age in both groups. Sodium intake did not vary with postnatal age. The percentage of fractional sodium excretion was inversely related to postnatal age. Creatinine clearance correlated directly with postnatal age in both groups. Increased sodium excretion and percentage of fractional sodium excretion in the first 10 days of life may reflect extracellular fluid solute losses through the kidney. The premature kidney matured in a balanced fashion and persistent respiratory morbidities did not alter this pattern.

Body Composition↗
PubMed1989

Second-generation consequences of small-for-dates birth.

This is the first reported study of birth outcomes of a group of women whose own birth weights and gestational ages had been previously recorded. Births occurring from 1972 to 1983 among 1154 Swedish women, born from 1955 to 1965, were studied. Women who were themselves small for gestational age (SGA) at birth were at increased risk of giving birth to a SGA infant (odds ratio = 2.21, 95% confidence interval = 1.41, 3.48). Women who had been SGA had an even greater increase in risk of giving birth to a preterm infant (odds ratio = 2.96, 95% confidence interval = 1.47, 5.94). Women who were preterm at birth were not at increased risk of giving birth to either preterm (odds ratio = 0.65, 95% confidence interval = 0.15, 2.74) or SGA (odds ratio 1.21, 95% confidence interval = 0.62, 2.38) infants. It is concluded that the long-term effects of intrauterine growth retardation may extend to the next generation; women who had been SGA should be considered at increased risk to give birth to both growth-retarded and preterm infants.

Adolescent↗