RESUMO
Purpose: The pathways by which adverse childhood experiences (ACEs) are associated with early marriage and early pregnancy are poorly understood. Early marriage and early pregnancy may be risk factors for adulthood intimate partner violence (IPV). The aim of this study was to assess the relationships among ACEs, early marriage, early pregnancy, and IPV among women in Honduras. Method: We used weighted data from 1,436 women aged 18-24 years from the nationally representative 2017 Honduras Violence Against Children and Youth Survey. We used path analysis to estimate relationships and accounted for sample design, non-response, and within-country clustering. Results: We found that ACEs had differential relationships with outcomes of interest. For example, witnessing violence in the community was directly associated with increased probability of early pregnancy (10 percentage points (PP); 95% CI: 0.04, 0.15) and IPV (6 PP; 95% CI: 0.01, 0.10), while emotional violence was not directly or indirectly associated with any outcome. Early marriage and early pregnancy had no direct or indirect effect on IPV, but the total effect of early marriage on IPV was significant. Conclusions: Understanding the relationship between ACEs, early marriage, early pregnancy, and IPV may help inform prevention efforts. For example, programs aiming to reduce early pregnancy may consider addressing sexual violence experienced in childhood.
RESUMO
OBJECTIVE: To evaluate the correlation between yolk sac diameter at 6 to 12 weeks of gestation measured via transvaginal ultrasound and adverse pregnancy outcomes. METHODS: This prospective cohort study was conducted at the Ain Shams University Maternity Hospital from July 1, 2019 to January 30, 2020. It included 120 pregnant women attending the outpatient clinic at 6 to 12 weeks of gestation. Transvaginal ultrasound was performed to measure inner yolk sac diameter. Normal diameter was considered to be 2-5 mm. Cases were followed up in routine antenatal care until the 16th week of gestation. RESULTS: Significant associations were found between maternal age and yolk sac diameter; yolk sac diameter and early miscarriage; a high percentage of cases of positive fetal life occurred when a normal yolk sac diameter (2-5 mm) was present (p<0.001); in yolk sac diameters <2mm positive fetal life was 0.0% and negative fetal life was 42.9%; in yolk sac diameters of 2-5mm positive fetal life was 81.1% and the negative fetal life was 7.1%; and in yolk sac diameters >5mm positive fetal life was 18.9% and negative fetal life was 50.0% (p<0.001), x2 60.094; and the best cutoff value for yolk sac diameter was >0.56, with a sensitivity of 78.6%, a specificity of 84.3%. CONCLUSIONS: We found a highly significant correlation between yolk sac diameter and early pregnancy loss.
Assuntos
Aborto Espontâneo , Resultado da Gravidez , Feminino , Gravidez , Humanos , Resultado da Gravidez/epidemiologia , Saco Vitelino/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia Pré-Natal , UltrassonografiaRESUMO
Este artigo é fruto de uma pesquisa que teve como objetivo analisar os fatores subjacentes à gravidez precoce em mães de recém-nascidos(as) internados(as) na Unidade de Terapia Intensiva Neonatal e na Unidade de Cuidados Intermediários Canguru da Maternidade Escola Januário Cicco, em Natal, Rio Grande do Norte. Parte-se do pressuposto de que esses fatores se agregam ao contexto de vida das adolescentes e influenciam diretamente em suas trajetórias e na gestação precoce. Trata-se de uma pesquisa de enfoque misto, a partir de um estudo do tipo exploratório, orientado pelo método dialético-crítico. Para a coleta de dados, foram realizadas oito (08) entrevistas semiestruturadas e um (01) grupo focal com adolescentes de 12 a 18 anos. Os dados foram submetidos à técnica de Análise de Conteúdo. Os resultados evidenciaram que o contexto de vida social, econômico, cultural e familiar de cada adolescente apresenta diversos fatores que influenciam nos significados da gravidez na adolescência e violam a garantia do exercício de direitos como liberdade, saúde, educação, trabalho e cultura, impactando na estruturação e nos projetos de vida dessa população.(AU)
This article derives from a research that aimed to analyze underlying factors of early pregnancy in mothers of newborns admitted to the Neonatal Intensive Care Unit and the 'Kangaroo Method' Intermediate Care Unit at Januário Cicco Maternity Ward in Natal, in the State of Rio Grande do Norte in Brazil. It is considered that these issues are combined to the adolescents' life context directly influence their trajectories and early pregnancy. The research is of mixed approach by means of an exploratory study guided by the dialectical-critical method. In order to collect data, eight (08) semi-structured interviews were realized as well as a focus group that considered adolescents aged from12 to 18 years old. Data was treated by means of Content Analysis. Results point out that the social, economic, cultural and familiar context of each adolescent enables a series of factors that influence and give meaning to teenage pregnancy. It was also seen that these issues violate the guarantee and exercise of rights such as freedom, health, education, work and culture, impacting the structures of their life projects.(AU)
Este artículo es fruto de una investigación que tuvo como objetivo analizar los factores subyacentes del embarazo precoz en madres de recién-nascidos(as) internados en la Unidad de Cuidados Intensivos Neonatal e en la Unidad de Cuidados Intermedios Canguru de la Maternidad Escuela Januário Cicco en Natal-Rio Grande do Norte en Brasil. Partiendo de la suposición de que esos factores se añaden al contexto de vida de las adolescentes e influencian directamente sus trayectorias y el embarazo precoz. Tratase de una investigación con enfoque mixto, a partir de un estudio de tipo exploratorio, orientado por el método dialéctico-crítico. Para la colecta de datos, fueron realizadas ocho (08) entrevistas semiestructuradas y un (01) grupo focal con adolescentes de 12 a 18 años. Los datos fueron sometidos a la técnica de Análisis de Contenido. Los resultados mostraron que el contexto de vida social, económico, cultural y familiar de cada adolescente presenta varios factores que influyen en los significados del embarazo adolescente y violan la garantía del ejercicio de derechos como libertad, salud, educación, trabajo y cultura, incidiendo en la estructuración y los proyectos de vida de esta población.(AU)
Assuntos
Humanos , Adolescente , Gravidez na Adolescência , Classe SocialRESUMO
OBJECTIVE: To investigate the effects of some potential risk factors on early pregnancy loss -EPL - in a cohort of pregnant women treated by assisted reproductive technology - ART. METHODS: This is a retrospective cohort of 195 pregnancies, defined as serum human chorionic gonadotrophins ≥ 10 IU/l on day 14 - 17 after embryo transfer, recruited from an assisted reproductive technology unit, Ain Shams & Al-Azhar Maternity hospital, Cairo, Egypt, during the period from January 1st, 2016 to December 31, 2020. Risk factors investigated were maternal age, body mass index, status, baseline hormonal profiles, treatment protocol, quality and number of embryos. RESULTS: Overall early pregnancy loss among the studied 195 pregnant women was 29 cases (15%). The risk of early pregnancy loss was associated with older age and fewer number of embryos transferred. Women > 35 years were found to have two and half times of early pregnancy loss compared with younger age group < 25 years, this was not significant after adjusting for other factors. The risk in both lean (BMI < 25 kg/m2) and very obese (BMI > 35 kg/m2) women was also not significantly higher in unadjusted analysis. Transfer of two or more embryos was associated with a non-significant reduced risk of early pregnancy loss, and after adjusting for other factors, the reduction was about 70%. CONCLUSIONS: Early pregnancy loss represents a considerable drawback of intracytoplasmic sperm injection treated women with old age to increase the risk of early pregnancy loss and transferring more than one embryo to reduce the risk by about 70%. Obesity and other factors appeared to play a minor role.
Assuntos
Aborto Espontâneo , Infertilidade , Gravidez , Feminino , Masculino , Humanos , Adulto , Injeções de Esperma Intracitoplásmicas/efeitos adversos , Fertilização in vitro/métodos , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologia , Estudos Retrospectivos , Sêmen , Infertilidade/etiologiaRESUMO
En Venezuela, el embarazo en adolescentes es un problema de salud pública, por su frecuencia, la repercusión sobre la calidad de vida de las madres, de sus hijos y de la sociedad en general; además, aun así, puede ser atendido y es factible su disminución. En 2014, Venezuela presentaba la Tasa Específica de Fecundidad más alta de Suramérica; y ocupaba el cuarto lugar, entre los países de Latinoamérica. Para estudiar el embarazo de adolescentes en el país se analizan los datos oficiales disponibles de la última década (2003-2012), en números, porcentajes y tasas. Asimismo, se analizan los nacimientos de madres adolescentes (2014/2015), recabados en dos hospitales públicos y dos privados: (11596 nacimientos: 2438 de madres adolescentes). De éstos: 2.403 (25,8%), en hospitales públicos y 35 (1,5%), en los privados. Del sector público, 95% de los hijos de adolescentes, son hijos de madres de 15 a 19 años y 5% de 10 a 14 años. Las tasas del grupo de 15 a 19 años (indicador oficial internacional), aumentaron en 2011 y 2012. Se analizan otras cifras y características: edad de las madres, frecuencia de legrado. En 2012, último año de información nacional disponible, se registraron (Instituto Nacional de Estadística-INE): 143 491 nacidos vivos, hijos de adolescentes, (10 a 19 años, según la OMS), que representan 23,4% del total anual de nacimientos. El embarazo en adolescentes constituye un fracaso social multisectorial, que recicla la pobreza y aumenta el subdesarrollo. Su importancia amerita la creación y aplicación de políticas públicas, así como estrategias específicas y permanentes para disminuir su incidencia(AU)
Abstract: Teenage pregnancy in Venezuela is a public health problem due to its incidence and repercussions over life-quality of mothers, their children, and the society in general. Even though with proper attention there is an incidence decrease possibility. In 2014 the Venezuelan Age-Specific Fertility Rate (15-19 age group) was the highest in South America and was the fourth among Latin America and the Caribbean nations. To study teenage pregnancy in the country last decade official available data (2003-2012) was analyzed by number, percentage, and rates. Between 2014 and 2015 the number of births from teenage mothers at two public and two private hospitals was analyzed (11 596 births: 2.438). Of those, 2.403 births were registered at public hospitals (25.8%) while 35 (1.5%) were at private clinic. At public hospitals 95% of live births were from teenage mothers (15-19 years) and 5% were mothers aged 10-14. In 2011 and 2012 the fertility rates for 1519-year-olds (international official indicator) increased. Other characteristics and tendencies are analyzed: age of mothers, abortion frequency and prenatal visits. According to the INE (National Institute of Statistics) in 2012, last year of available information, there were 143 491 live births from teenage mothers (aged 10-19 WHO) registered in Venezuela, which represents the 23.4% of the total number of annual births. Pregnancy of teenagers is a social multisectoral failure that recycles poverty and increase underdevelopment. The magnitude of the problem requires the design and implementation of public policies as well as specific permanent strategies to reduce the incidence(AU)
Assuntos
Humanos , Feminino , Gravidez , Criança , Adolescente , Gravidez na Adolescência , Qualidade de Vida , Classe Social , Fatores de Risco , Pobreza , Saúde Pública , Países em DesenvolvimentoRESUMO
Resumen OBJETIVO: Determinar el significado clínico y el desenlace obstétrico y perinatal luego de la detección de una protuberancia corial en el estudio de tamizaje del primer trimestre de la gestación. MATERIALES Y MÉTODOS: Estudio de cohorte prospectiva efectuado, de abril del 2019 a diciembre 2021, en pacientes referidas para tamizaje del primer trimestre a una unidad de Medicina y Cirugía Fetal de tercer nivel de referencia (Prenatalia Medicina Fetal San Javier, Guadalajara, Jalisco, México). Criterio de inclusión: pacientes con medición de la longitud cráneo caudal comprendida entre 45 y 84 mm durante el tamizaje prenatal del primer trimestre. Se reportaron los hallazgos ecográficos, se obtuvieron información y datos clínicos relevantes de los expedientes electrónicos y cuando se consideró necesario se contactó al ginecoobstetra tratante y a las pacientes. Se utilizó estadística descriptiva con medidas de tendencia central y dispersión. Para el análisis comparativo se utilizó χ2 y U de Mann Whitney para contrastar diferencias entre grupos. RESULTADOS: Se evaluaron 1359 embarazos y la protuberancia corial se documentó en 19 de ellos. En 9 de 19 casos se asoció con sangrado del primer trimestre, previo a la exploración ecográfica. En 16 de 19 casos se encontraron dimensiones de la protuberancia corial mayores a 10 mm. Además, la protuberancia se asoció con episodios de amenaza de parto pretérmino en 13 de los 19 casos. CONCLUSIONES: La protuberancia corial es un hallazgo poco frecuente durante el tamizaje del primer trimestre que se asocia con sangrado y episodios de amenaza de parto pretérmino.
Abstract OBJECTIVE: To determine the clinical significance and obstetric and perinatal outcome after detection of a chorionic protrusion in the first trimester screening study. MATERIALS AND METHODS: Prospective cohort study performed in patients referred for first trimester screening to a third level referral Fetal Medicine and Surgery unit (Prenatalia Medicina Fetal San Javier, Guadalajara, Jalisco, Mexico) from April 2019 to December 2021. Patients with craniocaudal length measurements between 45 and 84 mm during first-trimester prenatal screening were included. Ultrasound findings were reported, relevant clinical information and data were obtained from electronic records, and the treating obstetrician-gynecologist and patients were contacted when necessary. Descriptive statistics with measures of central tendency and dispersion were used. For comparative analysis, 2 and Mann Whitney U were used to contrast differences between groups. RESULTS: 1359 pregnancies were evaluated and chorionic protrusion was documented in 19 of them. In 9 of 19 cases it was associated with first trimester bleeding prior to ultrasound examination. Chorionic protrusion was found to be larger than 10 mm in 16 out of 19 cases. In addition, the protrusion was associated with episodes of threatened preterm labour in 13 of 19 cases. CONCLUSIONS: Chorionic protrusion is a rare finding during first trimester screening that is associated with bleeding and episodes of threatened preterm labour.
RESUMO
PROBLEM: A strong association between periodontitis and higher susceptibility to pregnancy complications like preeclampsia has been reported although the mechanisms remain elusive. Trophoblast cells modulate the recruitment and functional shaping of maternal leukocytes at early stages to sustain an antiinflammatory microenvironment and fetal growth. Neutrophil activation with reactive oxygen species (ROS) release is associated with preeclampsia. Our aim was to study the effect of the gingival crevicular fluid (GCF) from pregnant women on trophoblast cell function and trophoblast-neutrophil interaction. METHOD OF STUDY: Pregnant women at 16-20 weeks of gestation (n = 27) and non-pregnant women (n = 8) as the control group were studied for gingivoperiodontal clinical score evaluation and GCF collection. Total bacteria and common periodontal pathogens were analyzed in GCF samples. The effect of each GCF sample was tested on first trimester trophoblast-derived cells to assess cell migration, cytokine expression and glucose uptake. Also, the effect of GCF on human peripheral neutrophil chemoattraction by trophoblast cells and ROS formation was assessed. RESULTS: Gingival crevicular fluid from pregnant women reduced trophoblast cell migration, increased proinflammatory marker expression and glucose uptake. A significant correlation between gingivoperiodontal score and trophoblast dysfunction was observed. Upon conditioning of trophoblast cells with GCF, only the GCF from pregnant women stimulated neutrophil chemoattraction. Similarly, GCF from pregnant but not from non-pregnant controls stimulated ROS formation in neutrophils. CONCLUSIONS: Gingival crevicular fluid from pregnant women is deleterious for first trimester trophoblast cell function. These effects could lead to placental homeostasis disruption underlying a pathogenic mechanism of pregnancy complications associated to periodontal disease.
Assuntos
Pré-Eclâmpsia , Complicações na Gravidez , Feminino , Líquido do Sulco Gengival , Glucose , Humanos , Neutrófilos , Placenta , Gravidez , Espécies Reativas de Oxigênio , TrofoblastosRESUMO
OBJECTIVE: This study aimed to present a case of first-trimester uterine rupture and perform a systematic review to identify common presentations, risk factors, and management strategies. DATA SOURCES: Searches were performed in PubMed, Ovid, and Scopus using a combination of key words related to "uterine rupture," "first trimester," and "early pregnancy" from database inception to September 30, 2020. STUDY ELIGIBILITY CRITERIA: English language descriptions of uterine rupture at ≤14 weeks of gestation were included, and cases involving pregnancy termination and ectopic pregnancy were excluded. METHODS: Outcomes for the systematic review included maternal demographics, description of uterine rupture, and specifics of uterine rupture diagnosis and management. Data were extracted to custom-made reporting forms. Median values were calculated for continuous variables, and percentages were calculated for categorical variables. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports and case series. RESULTS: Overall, 61 cases of first-trimester uterine rupture were identified, including our novel case. First-trimester uterine ruptures occurred at a median gestation of 11 weeks. Most patients (59/61 [97%]) had abdominal pain as a presenting symptom, and previous uterine surgery was prevalent (44/61 [62%]), usually low transverse cesarean delivery (32/61 [52%]). The diagnosis of uterine rupture was generally made after surgical exploration (37/61 [61%]), with rupture noted in the fundus in 26 of 61 cases (43%) and in the lower segment in 27 of 61 cases (44%). Primary repair of the defect was possible in 40 of 61 cases (66%), whereas hysterectomy was performed in 18 of 61 cases (30%). Continuing pregnancy was possible in 4 of 61 cases (7%). CONCLUSION: Uterine rupture is an uncommon occurrence but should be considered in patients with an acute abdomen in early pregnancy, especially in women with previous uterine surgery. Surgical exploration is typically needed to confirm the diagnosis and for management. Hysterectomy is not always necessary; primary uterine repair is sufficient in more than two-thirds of the cases to achieve hemostasis. Continuing pregnancy, although uncommon, is also possible.
Assuntos
Gravidez Ectópica , Ruptura Uterina , Cesárea/efeitos adversos , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Gravidez Ectópica/etiologia , Ruptura Uterina/diagnóstico , Ruptura Uterina/epidemiologia , Ruptura Uterina/cirurgiaRESUMO
INTRODUCTION: A chorionic bump is an increasingly recognized ultrasound finding in first-trimester scans, which has been associated with early pregnancy loss. In ongoing second-trimester pregnancies, however, chorionic bumps usually resolve over time with no deleterious effect on the fetus. In this report, we describe the incidental ultrasound detection of a chorionic bump in early pregnancy and its progression to a subamniotic hematoma in the second trimester of pregnancy that persisted as such until delivery. CASE REPORT: A round, echogenic mass protruding from the choriodecidual surface measuring 13 × 11 × 8 mm was first identified during a transvaginal scan at 6.3 weeks' gestation. Subsequent follow-up scan at 8.3 weeks revealed an increase in the size of the chorionic bump to 25 × 20 × 19 mm, which remained stable as determined by the routine late first-trimester scan. At the second-trimester scan, a subamniotic hematoma was identified in the surface of the placenta, close to the insertion of the umbilical cord. Subsequently, the pregnancy proceeded uneventfully. DISCUSSION: The etiopathology and clinical significance of a chorionic bump remain unclear. The case herein reported demonstrates that a chorionic bump can grow considerably without having a deleterious effect on the early embryo and, occasionally, can persist throughout pregnancy as a subamniotic hematoma. CONCLUSION: A chorionic bump can occasionally progress to a subamniotic hematoma from the second trimester onwards. This observation further supports the hypothesis that a chorionic bump is the result of choriodecidual bleeding. An alternative explanation for the development of subamniotic hematomas is proposed.
RESUMO
Increasing productivity through continued animal genetic improvement is a crucial part of implementing sustainable livestock intensification programs. In Zebu cattle, the lack of sexual precocity is one of the main obstacles to improving beef production efficiency. Puberty-related traits are complex, but large-scale data sets from different "omics" have provided information on specific genes and biological processes with major effects on the expression of such traits, which can greatly increase animal genetic evaluation. In addition, genetic parameter estimates and genomic predictions involving sexual precocity indicator traits and productive, reproductive, and feed-efficiency related traits highlighted the feasibility and importance of direct selection for anticipating heifer reproductive life. Indeed, the case study of selection for sexual precocity in Nellore breeding programs presented here show that, in 12 years of selection for female early precocity and improved management practices, the phenotypic means of age at first calving showed a strong decreasing trend, changing from nearly 34 to less than 28 months, with a genetic trend of almost -2 days/year. In this period, the percentage of early pregnancy in the herds changed from around 10% to more than 60%, showing that the genetic improvement of heifer's sexual precocity allows optimizing the productive cycle by reducing the number of unproductive animals in the herd. It has a direct impact on sustainability by better use of resources. Genomic selection breeding programs accounting for genotype by environment interaction represent promising tools for accelerating genetic progress for sexual precocity in tropical beef cattle.
RESUMO
One of the most widely accepted axioms of reproductive biology is that pregnancy requires the sole support of progesterone, without which pregnancy cannot be established or maintained. We report a rare case of ongoing third trimester pregnancy in a 41-year-old woman, where early gestational period was maintained despite extremely low progesterone levels of <1 ng/ml, and was discovered during controlled ovarian hyperstimulation (COS) for in vitro fertilization (IVF). She was started on ovarian stimulation (OS) with gonadotrophins after a withdrawal bleed during lactational amenorrhea. Baseline investigations on day 2 of the menstruation confirmed low serum estradiol and progesterone levels (<1 ng/ml). After 5 days of stimulation, on ultrasound scan, a sac-like structure was seen in the uterine cavity. Beta hCG levels were measured and confirmed the presence of early pregnancy despite progesterone levels below 1 ng/ml. COS was stopped, and progesterone support was started. Subsequent scan confirmed live intrauterine pregnancy and the fetus is currently growing uneventfully at 31 weeks of gestation (at the time of writing this report).
Assuntos
Síndrome de Hiperestimulação Ovariana , Progesterona , Gravidez , Feminino , Humanos , Adulto , Gonadotropina Coriônica , Indução da Ovulação , Fertilização in vitro , EstradiolRESUMO
Maternal diabetes increases the risk of embryo resorptions and impairs embryo development. Decidualization is crucial for embryo development and regulated by mTOR signaling. However, little is known about how maternal diabetes affects the decidua at early postimplantation stages and whether dietary treatments enriched in polyunsaturated fatty acids (PUFAs) can prevent decidual alterations. Here, we determined resorption rates, decidual mTOR pathways and markers of decidual function and remodeling in diabetic rats fed or not with diets enriched in PUFAs exclusively during the early postimplantation period. Pregestational streptozotocin-induced diabetic Albino Wistar rats and controls were fed or not with diets enriched in 6% sunflower oil or 6% chia oil (enriched in n-6 or n-3 PUFAs, respectively) on days 7, 8 and 9 of pregnancy and evaluated on day 9 of pregnancy. Maternal diabetes induced an 11-fold increase in embryo resorptions, which was prevented by both PUFAs-enriched diets despite no changes in maternal glycemia. The activity of mTOR pathway was decreased in the decidua from diabetic rats, an alteration prevented by the PUFAs-enriched diets. PUFAs-enriched diets prevented increased expression of Foxo1 (a negative regulator of mTOR) and reduced expression of miR-21 (a negative regulator of Foxo1). These diets also prevented reduced markers of decidual function (leukemia inhibitory factor and IGFBP1 expression and MMPs activity) in diabetic rat decidua. We identified the early post implantation as a crucial stage for pregnancy success, in which dietary PUFAs can protect diabetic pregnancies from embryo resorptions, decidual mTOR signaling impairments, and altered markers of decidual function and remodeling.
Assuntos
Decídua/metabolismo , Gorduras na Dieta/administração & dosagem , Perda do Embrião/prevenção & controle , Ácidos Graxos Insaturados/farmacologia , Fenômenos Fisiológicos da Nutrição Pré-Natal , Serina-Treonina Quinases TOR/metabolismo , Fenômenos Fisiológicos da Nutrição Animal , Animais , Glicemia , Decídua/efeitos dos fármacos , Ácidos Graxos Insaturados/administração & dosagem , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/genética , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/metabolismo , Fator Inibidor de Leucemia/genética , Fator Inibidor de Leucemia/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Gravidez , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos , Serina-Treonina Quinases TOR/genéticaRESUMO
Embryonic death followed by resorption is a conserved process in mammals. Among the polyovular species, Lagostomus maximus (plains viscacha) constitutes a model of early and physiological embryonic death, since out of a total of 10-12 implants, 8-10 are resorbed during early/intermediate gestation, surviving are only the most caudal implantations of each uterine horn. This regular reproductive event is unique to this species, but many characteristics of the implantations during the early gestation of L. maximus, when embryonic death processes begin are unknown. The aim of the present work was to analyze the implantation sites of this species using morphological, morphometric, histochemical, lectinhistochemical, and immunohistochemical techniques to infer the possible causes of this event. Macroscopically, the length and width of the implantation sites significantly increased in a craniocaudal direction. Histochemically, the implantation sites did not differ in the expression of glycoconjugates and glycosidic residues. Furthermore, no variations were observed in cell renewal, hormone receptor expression, and decidualization. Both the glandular and vascular areas of the implantation sites significantly increased in the craniocaudal axis. Some necrotic cells and an inflammatory response with a predominance of lymphocytes and fibrin were observed in the cranial and middle but not in the caudal implantation sites. We conclude that signs of embryonic death and resorption are already observed in the early gestation of L. maximus. Our results reaffirm the hypothesis that postulates the key potential role of uterine glands and blood vessels in the gestation of the species, with emphasis on embryonic death. This pattern of embryonic death in L. maximus makes this species an unconventional mammalian model, which adds to the peculiarities of polyovulation (200-800 oocytes/estrus) and hemochorial placentation.
Assuntos
Eutérios , Roedores , Animais , Feminino , Hormônios , Placentação , Gravidez , ÚteroRESUMO
OBJETIVO: Descrever o perfil clínico e epidemiológico da gestação na adolescência buscando possíveis diferenças em relação à gestação em mulheres adultas. MÉTODOS: Estudo ecológico a partir de dados secundários (DATA-SUS). Foram estudadas três grupos de variáveis: as relacionadas à mãe, as relacionadas ao parto e as relacionadas ao RN. A análise dos dados foi realizada pelo Teste Qui-quadrado de independência, considerando-se significante P ≤ 0,05. Foram utilizadas planilhas do Microsoft Excel, versão 2013, software Epi Info v.7, para a obtenção do Odds Ratio (OR), com intervalo de confiança (IC) de 95%. RESULTADOS: Foram avaliadas 48.277 gestações, sendo 4.453 (9,22%) em adolescentes com idade média de 16,92 anos (+1,16), e 43.824 (90,78%) em mulheres adultas com idade média de 27,89 anos (+ 5,77). As mães adolescentes eram solteiras (54,61%) e brancas (98,02%) em sua maioria e apresentaram gestação única (98,92%). A prematuridade ocorreu em 10,21%, 61,5% dos partos foram vaginais, com 99,73% ocorridos em ambiente hospitalar. Com relação ao recém-nascido, 51,99% eram do sexo masculino e o baixo peso ao nascer foi de 9,57%. Apgar < 7 no 1º minuto foi de 16,63%, e no 5º minuto, 2,14%. A presença de anomalias congênitas em filhos de mães adolescentes foi de 1,15%. CONCLUSÃO: A gravidez na adolescência se associou com menor número de consultas de pré-natal, maiores taxas de prematuridade e baixo peso, com maior ocorrência de parto vaginal e de anomalias congênitas no RN.
OBJECTIVE: To describe the clinical and epidemiological profile of pregnancy in adolescence, searching possible differences in relation to pregnancy in adult women. METHODS: Ecological study based on secondary data (DATA-SUS). Three groups of variables were studied: those related to the mother, those related to childbirth and those related to the newborn. The data analysis was performed by the Qui-square test of independence, being considered significant P ≤ 0.05. Microsoft Excel spreadsheets, version 2013, Epi Info v.7 software were used to obtain the Odds Ratio (OR), with a 95% confidence interval (CI). RESULTS: A total of 48,277 pregnancies were evaluated, of which 4,453 (9.22%) were adolescents aged 16.92 +1.16 years, and 43,824 (90.78%) in adult women aged of 27.89 years +5.77. Adolescent mothers were single (54.61%) and white (98.02%) in the majority, and presented single gestation (98.92%). Prematurity occurred in 10.21%, and 61.5% of deliveries were vaginal. With regard to the newborn, 51.99% were male and the low birth weight occurred in 9.57%. Apgar <7 in the 1st and 5th minute was present in 16.63% and 2.14% respectively. The presence of congenital anomalies in children of adolescent mothers was 1.15%. CONCLUSION: Adolescent pregnancy was associated with: a lower number of prenatal appointments, higher rates of prematurity and low birth weight, higher incidence of vaginal delivery and congenital anomalies
RESUMO
BACKGROUND: Few investigators have evaluated the association between early pregnancy social support and depression; however, increased social support may improve mental health during pregnancy. Our objective is to examine whether in early pregnancy there is an association between social support and maternal depression among women in Peru. METHODS: 2,062 pregnant women participated in structured interviews. Early pregnancy social support was measured using the Social Support Questionnaire (SSQ-6). We evaluated the number of individuals that participants could turn to in different situations (Social Support Number Score; SSQN) and their satisfaction with support received (Social Support Satisfaction Score; SSQS). Median SSQN and SSQS characterized participants according to high and low levels of support. SSQN family vs. non-family support were also evaluated separately. Antepartum depression was assessed using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: 39.6% of women reported high SSQN and 45.5% reported high SSQS. Approximately 25% had antepartum depression. Women with high SSQN had 22% lower odds of antepartum depression (OR = 0.78; 95%CI: 0.63-0.97). Similarly, women with high SSQS scores had 45% lower odds of antepartum depression (OR = 0.55; 95%CI: 0.45-0.68). Women with high SSQN non-family scores had 30% lower odds antepartum depression compared to those with low SSQN non-family scores (OR = 0.70; 95%CI: 0.57-0.86). The association between SSQN family scores and antepartum depression did not reach statistical significance. CONCLUSION: Increased social support may improve maternal mental health during pregnancy and this association should be assessed in longitudinal studies.
Assuntos
Complicações na Gravidez , Gestantes , Depressão/epidemiologia , Feminino , Humanos , Peru/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Apoio SocialRESUMO
An alternative hyper-ovulator inducer to replace clomiphene citrate (CC) is needed as it is unsuitable for women with polycystic ovarian syndrome and is associated with low pregnancy rates. Anastrozole is an effective hyper-ovulator inducer, but has not been well researched. In order to determine the effectiveness of anastrozole as a hyper-ovulator inducer and to an extent compare it with CC in similar situations, this study ascertained the effects of these drugs on the expression of the focal adhesion proteins, paxillin and FAK, which are uterine receptivity markers in the surface luminal uterine epithelial cells of day 1 and day 6 pregnant Wistar rats. The results show that paxillin is localized in focal adhesions at the base of the uterine epithelial cells at day 1 of pregnancy whereas at day 6, paxillin disassembles from the basal focal adhesions and localizes and increases its expression apically. FAK is faintly expressed at the basal aspect of the uterine epithelial cells while moderately expressed at the cell-to-cell contact at day 1 in all groups from where it disassembles and relocates apically and becomes more intensely expressed at day 6 of pregnancy in untreated and anastrozole treated rats. Although paxillin is localized apically at day 6, its expression is significantly down-regulated with CC treatment suggesting its interference with the implantation process. These findings seem to suggest that anastrozole could favor implantation.
Para reemplazar el citrato de clomifeno (CC) es necesario un inductor de hiperovulación alternativo, ya que no es adecuado para mujeres con síndrome de ovario poliquístico y está asociado con tasas bajas de embarazo. El anastrozol es un inductor eficaz del hiper-ovulador, pero no se ha investigado adecuadamente. Con el fin de determinar la efectividad del anastrozol como inductor del hiper-ovulador y, en cierta medida, compararlo con CC en situaciones similares, este estudio determinó los efectos de estos fármacos en la expresión de las proteínas de adhesión focal, paxillin y FAK, uterinas marcadores de receptividad en la superficie luminal de células uterinas epiteliales, del día 1 y día 6 en ratas Wistar preñadas. Los resultados muestran que la paxilina se localiza en adherencias focales en la base de las células epiteliales uterinas en el día 1 del embarazo, mientras que en el día 6, la paxilina se desmonta de las adherencias focales basales y localiza y aumenta su expresión apicalmente. FAK se expresa débilmente en el aspecto basal de las células epiteliales uterinas, mientras que se expresa moderadamente en el contacto de célula a célula en el día 1 en todos los grupos, donde se separa y se reubica apicalmente y se expresa con mayor intensidad el día 6 de la preñez, en pacientes no tratados y tratados. ratas tratadas con anastrozol. Aunque la paxillina se localiza apicalmente en el día 6, su expresión está significativamente disminuida con el tratamiento con CC, lo que sugiere su interferencia con el proceso de implantación. Estos hallazgos sugieren que el anastrozol podría favorecer el proceso de implantación.
Assuntos
Animais , Feminino , Ratos , Útero/efeitos dos fármacos , Anastrozol/farmacologia , Ovulação/efeitos dos fármacos , Ratos Wistar , Adesões Focais/efeitos dos fármacos , Epitélio/efeitos dos fármacos , Proteína-Tirosina Quinases de Adesão Focal/efeitos dos fármacos , Paxilina/efeitos dos fármacos , Reação em Cadeia da Polimerase em Tempo Real , Microscopia de FluorescênciaRESUMO
The threat of Foot and Mouth Disease (FMD) in South America has global economic implications and retaining a FMD Free status under the World Organization for Animal Health (OIE) remains a top priority. In Argentina the Servicio Nacional de Sanidad y Calidad Agroalimentaria (SENASA), the national service of agri-food health and quality, requires cattle located in the Pampean region of the Salado River basin to receive two foot-and-mouth disease (FMD) vaccinations per year, which results in one vaccination coinciding with beef cattle breeding season. While the vaccination program remains necessary, there is a growing concern amongst food animal veterinarians, that the overlap of FMD vaccination with the first 35 days of the breeding season is associated with early pregnancy loss (EPL). To address this concern, a preliminary randomized controlled trial t study was conducted to investigate the risk ratio (RR) of EPL in vaccinated, pregnant Aberdeen Angus heifers. Initially (Day 0), 858 heifers underwent fixed time-AI (FTAI). Subsequently, on day 33, following pregnancy diagnosis by transrectal ultrasonography pregnant heifers (nâ¯=â¯311) were randomly allocated to two treatment groups. Group 1 (162 animals) received an inactivated oil emulsion FMD vaccine, and Group 2 (149 animals) received a saline injection (control). On day 51 (18 days post vaccination), pregnancy status was re-evaluated by ultrasonography. The initial pregnancy rate (PR) on Day 33 was 58% (498/858 animals). On Day 51 (18 days post vaccination), PR in Group 1 was 96.3% (156/162 animals), and in Group 2 (control) was 98.6% (147/149 animals). The EPL in Group 1 was 3.7% (6/162 animals) and in Group 2 was 1.3% (2/149 animals). The RR of EPL in Group 1, compared to Group 2, was 2.8 (95% confidence interval: 0.6-13, p-value: 0.20). With such a wide range in confidence intervals and a p value of 0.20 a larger prospective study would be necessary to establish an unequivocally statistically significant link between heifer vaccination 33 days post FTAI and an increased risk of EPL.
Assuntos
Aborto Animal/epidemiologia , Doenças dos Bovinos/prevenção & controle , Febre Aftosa/prevenção & controle , Vacinação/veterinária , Aborto Animal/etiologia , Animais , Argentina/epidemiologia , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/etiologia , Feminino , Gravidez , Taxa de Gravidez , Vacinação/efeitos adversosRESUMO
Anti-Müllerian Hormone (AMH) is a protein expressed in the gonads and related to ovarian follicular development. The aim of this study was to investigate the presence of polymorphisms in the AMH gene in a Nelore herd to analyze the genetic constitution of this population and to perform association studies with early pregnancy occurrence (EPO) and age at first calving (AFC). Phenotypic data consisted of verification of early pregnancy and age at first calving of 197 unrelated heifers exposed to the mating season and aged between 15 and 17 months (precocious group) and 24 months (non-precocious group). The precocious group consisted of 67 heifers with age at first calving of 26.5 ± 0.59 months, and the non-precocious group was composed of 130 heifers with age at first calving of 36.4 ± 0.99 months. All five exons of the AMH gene were amplified by Polymerase Chain Reaction (PCR) and sequenced. A total of three SNPs were identified in this study, all of them located in exon 5 (rs527023314, rs722016629, and rs134387246), the latter one positioned in the stop codon. All three SNPs identified in exon 5 characterized synonymous mutations. Only SNP rs134387246 exhibited a significant value (P ≤ 0.10) for EPO and AFC. The association study of SNP rs134387246 revealed an over-dominance effect (P = 0.056), and no additive effect was observed (P = 0.67). A reduction of 2.5 months (75 days) in the age at first calving of heterozygous heifers for the SNP rs134387246 was observed. For the first time, polymorphisms of the AMH gene were described in Nelore heifers and associated with sexual precocity traits.(AU)
O hormônio Anti-Mülleriano (AMH) é uma proteína expressa nas gônadas e está relacionada ao desenvolvimento folicular ovariano. O objetivo desse trabalho foi investigar a presença de polimorfismos do gene AMH em um rebanho Nelore, analisar a constituição genética da população para o gene e estudar a associação entre os polimorfismos e as características ocorrência de prenhez precoce (OPP) e idade ao primeiro parto (IPP). Os dados fenotípicos consistiram da verificação da prenhez precoce e idade ao primeiro parto de 197 novilhas, não aparentadas, expostas à estação de monta com idade entre 15 e 17 meses (grupo precoce) ou 24 meses (grupo não precoce). O grupo denominado precoce foi composto por 67 novilhas com idade ao primeiro parto de 26.5±0.59 meses, e o segundo denominado não precoce composto por 130 novilhas com idade ao primeiro parto de 36.4±0.99 meses. Os cinco éxons do gene AMH foram amplificados por meio da técnica de Reação em Cadeia da Polimerase (PCR) e sequenciados. Um total de três SNPs foram identificados nesse estudo, todos localizados no éxon 5 (rs527023314, rs722016629 and rs134387246), sendo o último posicionado stop codon. Os três SNPs identificados caracterizaram mutações sinônimas. Somente o SNP rs134387246 exibiu associação significante (P ≤ 0.10) para ambas características (OPP e IPP). O estudo de associação do SNP rs134387246 revelou um efeito de sobre dominância (P=0,056), e ausência de ação gênica aditiva (P=0,67). Foi observada redução de 2,5 meses (75 dias) na idade ao primeiro parto de novilhas heterozigotas para o SNP rs134387246. Pela primeira vez na literatura, polimorfismos do gene AMH foram descritos em novilhas da raça Nelore e associados a características indicadoras de precocidade sexual.(AU)
Assuntos
Animais , Feminino , Adulto Jovem , Bovinos , Hormônio Antimülleriano/genética , Hormônio Antimülleriano/análise , Polimorfismo Genético , Prenhez/genética , Parto , Reprodução/genética , Reação em Cadeia da Polimerase/veterinária , Reação em Cadeia da Polimerase/métodosRESUMO
Anti-Müllerian Hormone (AMH) is a protein expressed in the gonads and related to ovarian follicular development. The aim of this study was to investigate the presence of polymorphisms in the AMH gene in a Nelore herd to analyze the genetic constitution of this population and to perform association studies with early pregnancy occurrence (EPO) and age at first calving (AFC). Phenotypic data consisted of verification of early pregnancy and age at first calving of 197 unrelated heifers exposed to the mating season and aged between 15 and 17 months (precocious group) and 24 months (non-precocious group). The precocious group consisted of 67 heifers with age at first calving of 26.5 ± 0.59 months, and the non-precocious group was composed of 130 heifers with age at first calving of 36.4 ± 0.99 months. All five exons of the AMH gene were amplified by Polymerase Chain Reaction (PCR) and sequenced. A total of three SNPs were identified in this study, all of them located in exon 5 (rs527023314, rs722016629, and rs134387246), the latter one positioned in the stop codon. All three SNPs identified in exon 5 characterized synonymous mutations. Only SNP rs134387246 exhibited a significant value (P ≤ 0.10) for EPO and AFC. The association study of SNP rs134387246 revealed an over-dominance effect (P = 0.056), and no additive effect was observed (P = 0.67). A reduction of 2.5 months (75 days) in the age at first calving of heterozygous heifers for the SNP rs134387246 was observed. For the first time, polymorphisms of the AMH gene were described in Nelore heifers and associated with sexual precocity traits.
O hormônio Anti-Mülleriano (AMH) é uma proteína expressa nas gônadas e está relacionada ao desenvolvimento folicular ovariano. O objetivo desse trabalho foi investigar a presença de polimorfismos do gene AMH em um rebanho Nelore, analisar a constituição genética da população para o gene e estudar a associação entre os polimorfismos e as características ocorrência de prenhez precoce (OPP) e idade ao primeiro parto (IPP). Os dados fenotípicos consistiram da verificação da prenhez precoce e idade ao primeiro parto de 197 novilhas, não aparentadas, expostas à estação de monta com idade entre 15 e 17 meses (grupo precoce) ou 24 meses (grupo não precoce). O grupo denominado precoce foi composto por 67 novilhas com idade ao primeiro parto de 26.5±0.59 meses, e o segundo denominado não precoce composto por 130 novilhas com idade ao primeiro parto de 36.4±0.99 meses. Os cinco éxons do gene AMH foram amplificados por meio da técnica de Reação em Cadeia da Polimerase (PCR) e sequenciados. Um total de três SNPs foram identificados nesse estudo, todos localizados no éxon 5 (rs527023314, rs722016629 and rs134387246), sendo o último posicionado stop codon. Os três SNPs identificados caracterizaram mutações sinônimas. Somente o SNP rs134387246 exibiu associação significante (P ≤ 0.10) para ambas características (OPP e IPP). O estudo de associação do SNP rs134387246 revelou um efeito de sobre dominância (P=0,056), e ausência de ação gênica aditiva (P=0,67). Foi observada redução de 2,5 meses (75 dias) na idade ao primeiro parto de novilhas heterozigotas para o SNP rs134387246. Pela primeira vez na literatura, polimorfismos do gene AMH foram descritos em novilhas da raça Nelore e associados a características indicadoras de precocidade sexual.
Assuntos
Feminino , Animais , Adulto Jovem , Bovinos , Hormônio Antimülleriano/análise , Hormônio Antimülleriano/genética , Parto , Polimorfismo Genético , Prenhez/genética , Reprodução/genética , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterináriaRESUMO
Uterine receptivity and embryo implantation are two main processes that need a finely regulated balance between pro-inflammatory and tolerogenic mediators to allow a successful pregnancy. The neuroimmune peptide vasoactive intestinal peptide (VIP) is a key regulator, and it is involved in the induction of regulatory T cells (Tregs), which are crucial in both processes. Here, we analyzed the ability of endogenous and exogenous VIP to sustain a tolerogenic microenvironment during the peri-implantation period, particularly focusing on Treg recruitment. Wild-type (WT) and VIP-deficient mice [heterozygous (HT, +/-), knockout (KO, -/-)], and FOXP3-knock-in-GFP mice either pregnant or in estrus were used. During the day of estrus, we found significant histological differences between the uterus of WT mice vs. VIP-deficient mice, with the latter exhibiting undetectable levels of FOXP3 expression, decreased expression of interleukin (IL)-10, and vascular endothelial growth factor (VEGF)c, and increased gene expression of the Th17 proinflammatory transcription factor RORγt. To study the implantation window, we mated WT and VIP (+/-) females with WT males and observed altered FOXP3, VEGFc, IL-10, and transforming growth factor (TGF)ß gene expression at the implantation sites at day 5.5 (d5.5), demonstrating a more inflammatory environment in VIP (+/-) vs. VIP (+/+) females. A similar molecular profile was observed at implantation sites of WT × WT mice treated with VIP antagonist at d3.5. We then examined the ability GFP-sorted CD4+ cells from FOXP3-GFP females to migrate toward conditioned media (CM) obtained from d5.5 implantation sites cultured in the absence/presence of VIP or VIP antagonist. VIP treatment increased CD4+FOXP3+ and decreased CD4+ total cell migration towards implantation sites, and VIP antagonist prevented these effects. Finally, we performed adoptive cell transfer of Tregs (sorted from FOXP3-GFP females) in VIP-deficient-mice, and we observed that FOXP3-GFP cells were mainly recruited into the uterus/implantation sites compared to all other tested tissues. In addition, after Treg transfer, we found an increase in IL-10 expression and VEGFc in HT females and allowed embryo implantation in KO females. In conclusion, VIP contributes to a local tolerogenic response necessary for successful pregnancy, preventing the development of a hostile uterine microenvironment for implantation by the selective recruitment of Tregs during the peri-implantation period.