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To investigate the management and survival of very preterm singletons born because of fetal growth restriction (FGR) with or without maternal hypertensive disorders in France. From a population-based cohort of very preterm births between 22 and 31 weeks in France in 2011, the study population included all non-anomalous singleton pregnancies delivered because of detected FGR with or without maternal hypertensive disorders. Antenatal detection of FGR was defined as an estimated fetal weight <10th percentile with or without fetal Doppler abnormalities or growth arrest. All fetuses were alive at the time of detection of FGR. Indicators of active perinatal management (antenatal steroids, pre-labor cesarean and birth in level 3 maternity unit) and fetal/neonatal outcomes (terminations of pregnancy (TOP), stillbirths, neonatal deaths and survival to discharge) were compared by gestational age between FGR associated with maternal hypertensive disorders and isolated FGR. Overall, 398 pregnancies delivered before 32 weeks for FGR associated with hypertensive disorders and 234 for isolated FGR. Active perinatal care was rare before 26 weeks in both groups and about one in five cases associated with maternal hypertensive disorders received steroids and was born by prelabor cesarean compared to none for isolated FGR. Before 25 weeks of gestation age, more pregnancies resulted in TOP when FGR was associated with hypertensive disorders compared to isolated FGR (respectively, 76.2 % vs 28.0 % at 22–23 weeks, P = 0.002 and 57.9 % vs 21.1 % at 24 weeks, P = 0.028) whereas stillbirths were more common among isolated FGR (respectively, 23.8 % vs 72.0 % at 22–23 weeks, P = 0.002 and 36.8 % vs 73.7 % at 24 weeks, P = 0.030). Survival to discharge was higher at any gestational age when the cause of birth was FGR associated with hypertensive disorders compared to isolated FGR. The management and pregnancy outcomes differed when FGR was associated with maternal hypertensive disorders or isolated. The proportion of TOP was higher when FGR was associated with hypertensive disorders and the proportion of stillbirths was higher in isolated FGR. [ABSTRACT FROM AUTHOR]

To evaluate the outcome of a case series of women with advanced abdominal pregnancies (AAP) who underwent expectant management. A retrospective study that utilized prospective data of 46 women who were admitted for expectant management at a tertiary hospital in Durban, South Africa. All data was analyzed descriptively and presented in percentages. The average period of expectant management was 27 days; thirty-three (72 %) of the 46 women were discharged from the hospital with live babies. There were 11 (24 %) neonatal deaths and two cases of stillbirths. There were no maternal deaths and morbidity was minimal. When diagnosed after the 24th week of gestation, an option is expectant management which includes careful patient selection, prolonged hospitalization, and close antenatal fetal and maternal surveillance to achieve fetal viability. Management by experienced clinicians and a multidisciplinary team in a tertiary institution is recommended. Informed consent needs to take into consideration the risks with interventional laparotomy, social separation from family and friends, and the guarded perinatal outcome. [ABSTRACT FROM AUTHOR]

Introduction: This study aims at observing placental pathologies in COVID-19 infected women, and analyzing its impact on pregnancy outcome.Method: This is a descriptive-analytical study done at a tertiary centre of Northern India. All COVID-19 positive pregnant women with gestational age ≥20 weeks, with placental histopathological reporting, were included in this study. A total of 173 COVID-19 pregnant women were included in the study.Results: Placental abnormalities were noticed in 49·16% of total 179 placentae examined. Maternal vascular malperfusion (27·93%) was the most observed placental pathology followed by villous fibrin deposits (22·90%), fetal vasculopathy (16·75%), and acute inflammation (6·70%). Stillbirths were 22 and NICU admissions were seen in 50 neonates. Abnormal placental abnormalities led to higher stillbirths (p value 0·011) and lower Apgar scores at 1 and 5 min (p-value 0·028; p-value 0·002, respectively). Intervillous fibrin deposits had higher risk associated with lower Apgar score at 1 and 5 min [RR 2·05 (95% CI 1·21-3·48, p-value 0·010) and RR 5·52 (95% CI 2·58-11·81, p-value <0·001), respectively]. RP clot/hemorrhage was also associated with lower Apgar score at 1 and 5 min [RR 2·61 (95% CI 1·52-4·49, p-value 0·002) and RR 3.54 (95% CI 1·66-7·55, p-value 0·001), respectively].Discussion: Placental abnormalities in COVID-19 infection were associated with significant higher incidence of unexplained stillbirths, and lower Apgar scores. Although, this is the largest descriptive-analytical study done so far, comparative studies are required to draw a clear conclusion regarding the impact of COVID-19 infection on human placenta and its effect on pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Objective: An examination of the synergistic effects of maternal obesity and macrosomia on the risk of stillbirth is lacking. The purpose of this study was to determine the association between fetal macrosomia, maternal obesity, and the risk of stillbirth.Methods: This retrospective cross-sectional study used the CDC's Birth Data and Fetal Death Data files for 2014-2017 [n = 10,043,398‬ total births; including 48,799 stillbirths]. The exposure was fetal macrosomia stratified by obesity subtypes (I-III). The outcome was the risk of stillbirth. We also controlled for potential and known confounding factors in adjusted models. Adjusted Relative Risks (ARR) were estimated with log-binomial regression models.Results: The rate of stillbirth was higher among macrosomic infants born to mothers with obesity compared to those without (6.55 vs. 0.54 per 1000 total births). After controlling for confounding, women with obesity types II and III were at increased risk for stillbirth [Obesity II ARR = 2.37 (2.07-2.72); Obesity III ARR = 9.06 (7.61-10.78)].Conclusions For Practice: Obesity-related fetal overgrowth is a significant risk factor for stillbirth, especially among women with type II and type III obesity. This finding highlights the need for more effective clinical and public health strategies to address pre-pregnancy obesity and to optimize gestational weight gain. [ABSTRACT FROM AUTHOR]

Canine dystocia is a common problem that increases the risk of mortality to the dam and stillbirths for the pups. Understanding the risk factors for dystocia and stillbirth can help guide decision making to improve outcomes of whelping management. This study aimed to 1) evaluate risk factors for canine dystocia; and 2) assess risk factors for stillbirth in puppies, by examining all whelpings and puppies born in two breeding populations of guide dogs for a defined period of time. Dystocia risk factors were evaluated using a repeated measures model on 2,489 litters with an overall dystocia rate of 23.8%. Risk factors identified for dystocia were colony, litter size, and age of dam. Small litter size (<5 pups) had the highest dystocia rate of 36.5%, large litter size (>9 pups) had an intermediate dystocia rate of 26.9% and medium litter size had the lowest dystocia rate of 22.1%. Dystocia risk increased as the age of dam increased. Stillbirth risk factors were evaluated for 19,577 pups and the overall stillbirth rate was 5.9%. Risk factors identified for stillbirths were dystocia, litter size, cesarean section performed and breed. Pups from litters that had dystocia were 2.35 times more likely to be stillborn compared with normal litters born without dystocia. Stillbirth risk increased as litter size increased. Pups from litters of 11 or more pups were 1.45 times more likely to be stillborn. Specific information was available for a subset of pups and was used to evaluate the association with stillbirth. Low birth weight was associated with increased stillbirth risk but large pups were also at higher risk of stillbirth compared with average size pups. Stillborn pups had longer mean (102 vs 65 min) and median (47 and 32 min) inter-pup intervals compared with live pups. The positive predictive values for stillbirth were 13.5%, 28.4%, 31.8% and 36.5% when inter-pup interval threshold was set at 1, 2, 3 and 4 h respectively. There is a tradeoff between over diagnosing stillbirth and increased positive predictive value for stillbirth when inter-pup interval threshold is extended but the improvements were modest after 2 h. The last pup born in a litter regardless of litter size was significantly more likely to be stillborn. In conclusion, this paper details data driven parameters to use when making the decision to intervene during whelping that optimize survival for dams and puppies. • Risk factors for canine dystocia include colony, litter size and age of dam. • Risk factor for canine stillbirths include dystocia, cesarean section, litter size and breed. • Low birth weight and high birth weight pups were more likely to be stillborn. • Stillborn pups had longer inter-pup interval compared with pups born alive. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and indications of terminations of pregnancy (TOP) between 22+0 and 31+6 weeks of gestational age in France and to examine the characteristics of women by indication of TOP.Study Design: From the EPIPAGE 2 population-based cohort study of preterm births in France in 2011, we selected 5009 singleton live births, stillbirths and TOP that occurred between 22 and 31 weeks. We estimated the proportion of TOP by gestational age. We then classified terminations by indications into 4 categories: fetal anomalies (TOPFA), preterm premature rupture of the membranes (PPROM), maternal conditions and fetal growth restriction (FGR). We also classified TOPFA by type of anomaly. Maternal characteristics were compared between TOPFA and TOP for maternal or fetal conditions without congenital anomaly.Results: 23.1% of all births and 54.3% of stillbirths were terminations. The proportion of terminations was 36.9% of all births at 22 weeks, 50.2% at 24 weeks and <10% at 30-31 weeks. 85.8% of terminations were for fetal anomaly, 4.4% for PPROM, 6.1% for maternal complications and 3.7% for severe FGR. Compared to women with a TOPFA, those with a termination for maternal or fetal conditions were more often nulliparous, single, African, obese, smokers and covered by non-standard insurance for women in socially deprived circumstances.Conclusion: In France, there is a high proportion of TOP of which 14% are for indications other than congenital anomalies. Because rates of terminations have an impact on very preterm birth and perinatal mortality rates, studies on pregnancy outcome should report all terminations, not only those for congenital anomalies. [ABSTRACT FROM AUTHOR]

Abstract This paper explores loss in childbearing in Malawi (miscarriages, perinatal deaths and maternal mortality) as a lens to understand accountability and health system functioning. In low-income countries, maternal and perinatal mortality reflects poor health system functioning, to be improved in part through accountability. Understanding how accountability plays out on the ground requires examination of the existing, 'organic' accountability relationships and mechanisms. Thematic and discourse analysis of interviews and observations illuminates vocabularies of responsibility and practices of accountability concerning loss. Women are especially held accountable for loss, by a range of social actors. They use existing 'organic' accountability relationships and mechanisms to manage their own interests, but arguably also to care for pregnant women, even though negative birth experiences may ensue. Instances of disrespectful care appear a by-product of the convergence of organic and orchestrated, policy-driven accountability for numeric outcomes (deaths averted) rather than process (quality of care). Moreover, in the absence of essential physical resources, providers and relatives mobilize the social resources at their disposal to keep women and babies alive. Improving quality of care requires acknowledgment that providers' actions are both systemic and situational, and embedded in local moral landscapes and uneven webs of accountability. Highlights • Women are frequently held accountable for loss, by practitioners and communities. • Care is shaped by accountability relationships between a wide range of social actors. • Converging organic and orchestrated accountability may result in disrespectful care. • 'Disrespect and abuse' could be seen as care for the survival of women and babies. • Providers' actions are systemic and situational, and embedded in accountability webs. [ABSTRACT FROM AUTHOR]

Due to global warming, an increased number of open fires is becoming a major contributor to PM 2.5 pollution and thus a threat to public health. However, the burden of stillbirths attributable to fire-sourced PM 2.5 is unknown. In low- and middle-income countries (LMICs), there is a co-occurrence of high baseline stillbirth rates and frequent firestorms, which may lead to a geographic disparity. Across 54 LMICs, we conducted a self-matched case-control study, making stillbirths comparable to the corresponding livebirths in terms of time-invariant characteristics (e.g. , genetics) and duration of gestational exposure. We established a joint-exposure-response function (JERF) by simultaneously associating stillbirth with fire- and non-fire-sourced PM 2.5 concentrations, which were estimated by fusing multi-source data, such as chemical transport model simulations and satellite observations. During 2000–2014, 35,590 pregnancies were selected from multiple Demographic and Health Surveys. In each mother, a case of stillbirth was compared to her livebirth(s) based on gestational exposure to fire-sourced PM 2.5. We further applied the JERF to assess stillbirths attributable to fire-sourced PM 2.5 in 136 non-Western countries. The disparity was evaluated using the Gini index. The risk of stillbirth increased by 17.4% (95% confidence interval [CI]: 1.6–35.7%) per 10 μg/m3 increase in fire-sourced PM 2.5. In 2014, referring to a minimum-risk exposure level of 10 μg/m3, total and fire-sourced PM 2.5 contributed to 922,860 (95% CI: 578,451–1,183,720) and 49,951 (95% CI: 3,634–92,629) stillbirths, of which 10% were clustered within the 6.4% and 0.6% highest-exposure pregnancies, respectively. The Gini index of stillbirths attributable to fire-sourced PM 2.5 was 0.65, much higher than for total PM 2.5 (0.28). Protecting pregnant women against PM 2.5 exposure during wildfires is critical to avoid stillbirths, as the burden of fire-associated stillbirths leads to a geographic disparity in maternal health. [Display omitted] • Stillbirth has been linked to PM 2.5 exposure. • Many stillbirths are from low-income regions. • Many low-income regions are hotspots of wildfire. • Fire-sourced PM 2.5 was found as a key contributor to stillbirths. • Fire-related stillbirths were spatially clustered, leading to an inequality. [ABSTRACT FROM AUTHOR]

The occurrence of asphyxia in sows during parturition often results in stillbirths and low vitality piglets, thus significantly affecting pig production and animal welfare in terms of piglet mortality. The losses during farrowing can account to a significant loss in a litter, a whole litter or in extreme cases, the loss of the sow. The objective of this study was to develop an infrared depth image sensor-based monitoring system as a surveillance support system for stockmen during the farrowing phase of sows, in an effort to reduce piglet mortality associated with asphyxiation of piglets. Experiments were performed at Jurong Research farm of Nanjing Agricultural University, using a herd of 105 Meishan sows. Data was collected by monitoring the farrowing process of 15 sows housed in farrowing pens. The sows were monitored by video recording for labeling and depth images taken at 10 fpm for automatic system development. Data labeling was based on the timestamps of births of all the piglets in a litter and each piglet vitality score based on the number of times a piglet attempts to stand within the 1st minute after birth. Data labeling was performed 1 h before the start of parturition until 0.5 h after the end of parturition. The depth images were processed to segment the piglets, and a developed parametrized ellipse-fitting algorithm performed piglet detection by multi-ellipse fitting. Piglet count and count tracking were established by the number of fitted ellipses on the image-object shape. Each sequential increment in the piglet count was used to compute the inter-birth interval. The developed model attained a detection accuracy of 0.832 for no piglets and 0.801 for 14 piglets in a range of 0 to 14 piglets in a litter. In piglet counting and count tracking, the model achieved an average accuracy of 0.918 (R2) at an RMSE of 1.225 piglets. For the classification of an asphyxia event, the model indicated an accuracy of 0.863, specificity of 0.921, precision of 0.791, and a sensitivity of 0.723. The developed system can serve as part of Precision Livestock Farming automatic farrowing monitoring system with the aim of detecting the start of parturition, piglet count tracking, and asphyxia occurrence. [ABSTRACT FROM AUTHOR]

The profitability of pig production is constrained by high incidences of peri-parturient and pre-weaning piglet mortality. Supplementing sows with either progesterone or caffeine during the last week of gestation can reduce stillbirths and improve piglet performance. However, the consequences of combining these two substances has not been investigated. The aim of the current study was to determine the effect of oral supplementation of sows with progesterone (regumate) and caffeine at the end of gestation on the timing and progression of farrowing, as well as piglet survival and growth to weaning. From days 111 to 113 of gestation, 20 Large White pregnant sows (parity 3.0±0.45) received 5 ml of Regumate Porcine (0.4 w/v oral solution; MSD Animal Health) daily on top of their morning ration. Sows were stratified according to parity and predicted farrowing date, and allocated at random to receive a diet supplemented with either 0 g caffeine/kg diet (CONT) or 2.4 g of caffeine/kg diet (CAFF) from day 113 of gestation until parturition ( n =10 sows/treatment). Treatment did not affect total litter size; however, CONT sows gave birth to more live and fewer dead piglets compared with CAFF sows; 14.5±0.73 v. 11.7±1.03 and 0.7±0.20 v. 3.2±0.77; P <0.05). Mean, minimum and maximum piglet birthweight were unaffected by treatment. Compared with the control, caffeine increased the proportion of piglets with a birthweight <1 kg (0.16±0.05 v. 0.05±0.02; P =0.072) and decreased the proportion of live born piglets surviving to day 5 postpartum (0.77±0.06 v. 0.90±0.02; P <0.05) and to weaning (0.74±0.06 v. 0.90±0.02; P <0.05). Overall, the current data provided the first evidence that caffeine supplementation of sows receiving progesterone to prevent premature farrowing impaired piglet survival during, and shortly after parturition. This negative outcome may be linked to extended farrowing durations and an increase in the proportion of very light piglets at birth. These data provide compelling, albeit preliminary, evidence that caffeine and progesterone should not be used together at the end of gestation. [ABSTRACT FROM AUTHOR]

Supplementation of diets with omega-3 polyunsaturated fatty acids (PUFA) may benefit sow reproductive performance, but the efficiency of algae as a source of PUFA is still unknown. This study evaluated serum levels of metabolic markers and reproductive performance of sows supplemented with the heterotrophic microalgae Schizochytium sp . Sows (n = 596) were supplemented from the 85th day of gestation, during lactation and until the weaning-estrous interval (WEI). Microalgae were included at five levels: 0 (control); 3.5; 7.0; 14.0; and 28.0 g/d. Blood samples were collected at the 85th day of gestation, at the 10th d of lactation and at the last day prior to weaning (WEI). Serum levels of cholesterol, triglycerides, insulin-like growth factor type-1 (IGF-1) and non-esterified fatty acids (NEFA) were evaluated. At the parity concurrent with the supplementation, no effects were observed on stillborn rates (P > 0.05), sows fed 28.0 g/d farrowed heavier piglets than sows fed lower levels (P < 0.05), but the WEI for sows fed 7.0 g/d was longer than for the control (P < 0.05). Serum levels of triglycerides were decreased during gestation, only for sows supplemented with 14.0 and 28.0 g/d (P < 0.05). At the subsequent parity, there was no difference on stillborn rates and total litter size (P > 0.05). The highest tested concentration (28.0 g/d) of Schizochytium sp . was associated with reduced serum levels of triglycerides during gestation and with increased piglet birth weight, but the supplementation generally did not benefit sow reproductive performance. [ABSTRACT FROM AUTHOR]

Although perfluorohexane sulfonate (PFHxS) is structurally similar to perfluorooctane sulfonate (PFOS) and also widely detected in humans and the environment, comparatively fewer toxicity data exists on this 6-chain perfluoroalkyl sulfonic acid. In this study, repeated oral doses of PFHxS were administered to deer mice (Peromyscus maniculatus) to evaluate subchronic toxicity and potential effects on reproduction and development. Maternal oral exposure to PFHxS caused increased stillbirths, which is relevant for ecological risk assessment, and resulted in a benchmark dose lower limit (BMDL) of 5.72 mg/kg-d PFHxS. Decreased plaque formation, which is relevant for human health risk assessment, occurred in both sexes of adult animals (BMDL = 8.79 mg/kg-d PFHxS). These data are the first to suggest a direct link between PFHxS and decreased functional immunity in an animal model. Additionally, female animals exhibited increased liver:body weight and animals of both sexes exhibited decreased serum thyroxine (T4) levels. Notably, since reproductive effects were used to support 2016 draft health advisories and immune effects were used in 2022 drinking water health advisories released by the United States Environmental Protection Agency for PFOS and perfluorooctanoic acid (PFOA), these novel data can potentially support advisories for PFHxS because relevant points of departure emerge at similar thresholds in a wild mammal and corroborate the general understanding of per- and polyfluoroalkyl substances (PFAS). • Maternal exposure to PFHxS increased stillbirths in Peromyscus maniculatus. • Adult Peromyscus exposed to PFHxS displayed decreased plaque forming cells. • Wild mammalian PFHxS toxicity data are novel and valuable for effect estimation. • PFHxS functional immunity data are novel and valuable for risk estimation. [ABSTRACT FROM AUTHOR]

Background Fetal movement is the most common method to evaluate fetal well-being. Furthermore, maternal perception of decreased fetal movements is associated with perinatal demise. Previously, we showed that perception of decreased fetal movements was the most common reason for mothers visiting the outpatient department among those who had stillbirths in our region. Further investigation of stillbirths with decreased fetal movements is essential to find a possible way of preventing stillbirth. Aim To investigate maternal reaction time after their perceiving decreased fetal movements among stillbirths in our region of Japan. Methods This is a population-based study of stillbirths in Shiga Prefecture, Japan conducted from 2007 to 2011. We sent a questionnaire to each obstetrician who had submitted the stillbirth certificate. We reviewed and evaluated the questionnaires returned from the obstetricians. Findings There were 66 cases (35%) with decreased fetal movements among 188 stillbirths in Shiga during the study period. The number of maternal visits to outpatient department after perception of decreased fetal movements within 24 h was only seven (11%) among 64 stillbirths diagnosed at outpatient department. Conclusion We conclude that delayed maternal visit after perceiving decreased fetal movements is frequently observed in stillbirths. Promoting more thorough maternal education on fetal movements, including emphasizing earlier visitation after perceiving decreased fetal movements, may prevent stillbirths. [ABSTRACT FROM AUTHOR]

Genetic parameters and environmental factors were estimated for foaling ease (FE) and stillbirths (SBs) in four breeds of draft horses based on 11 229, 38 877, 35 764 and 13 274 FE and SB scores recorded between 1998 and 2010 for Ardennais (A), Breton (B), Comtois (C) and Percheron (P), respectively. Incidences for the three FE categories were: easy or without help 91.0% (A) to 95.4% (B), difficult 3.4% (B) to 7.1% (A) and intervention of a veterinarian 1.1% (B) to 1.9% (A). The frequency of SB ranged between 5.4% (B) and 9.4% (A). A multiple-trait threshold animal model was used that included the effects of sex of foal, region, month, year of foaling, combined maternal age and parity, direct genetic, maternal genetic and permanent environments. Estimates were obtained using Markov Chain Monte Carlo Gibbs sampling. The most unfavourable effect was first parity, which decreased the probability of easy foaling to 78.6% for A and 88.3% for B. Interaction with age showed that the risk for first foaling for mares aged 3 years was higher than at 4 or 5 to 9 years. This was also observed for SB with an increased probability of SB at first foaling of 17.9% (A) or 9.6% (B). The most unfavourable month was found to be the most frequent month for foaling (April) and not the most demanding months weather-wise (winter). For FE, direct heritabilities were A 0.27 (0.06), B 0.14 (0.03), C 0.18 (0.03) and P 0.18 (0.04), and maternal heritabilities were A 0.25 (0.06), B 0.19 (0.04), C 0.12 (0.03) and P 0.21 (0.06). Genetic correlations between direct and maternal genetic effects were A −0.29 (0.14), B −0.39 (0.12), C −0.09 (0.14) and P −0.54 (0.17). For SB, direct heritabilities were A 0.52 (0.09), B 0.42 (0.04), C 0.28 (0.04) and P 0.39 (0.05), and maternal heritabilities were A 0.25 (0.05), B 0.10 (0.02), C 0.07 (0.02) and P 0.14 (0.02). Genetic correlations between direct and maternal genetic effects were A −0.85 (0.06), B −0.63 (0.06), C −0.64 (0.11) and P −0.69 (0.06). Direct genetic correlations between FE and SB traits were A 0.60 (0.10), B 0.58 (0.10), C 0.36 (0.10) and P 0.29 (0.15). Maternal genetic correlations between FE and SB traits were A 0.67 (0.10), B 0.47 (0.13), C 0.28 (0.15) and P 0.39 (0.15). These estimates are posterior means of the Gibbs samples and are within the upper limits of comparable results reported in cattle. [ABSTRACT FROM PUBLISHER]

Abstract: The objective of this paper was to analyze the effects of non-genetic factors affecting calving ease and stillbirths in the population of 1257 Holstein cows, using classification trees. The trees were developed according to the following splitting criterion: the Pearson chi-squared test, entropy function and the Gini index. The quality of decision tree models were compared, taking into consideration the following criteria: the average squared error, misclassification rate, cumulative lift, Kolmogorov–Smirnov statistics and the area under curve of the Receiver Operating Characteristic. A statistical analysis was conducted using the Enterprise Miner 7.1 software included in the SAS package. The calculated quality criteria of the three models that were developed lead to the conclusion that the classification trees established based on the chi-squared statistic and entropy function most accurately define the variability of calving ease. In turn, in the event of stillbirths, classification tree models were identical regardless of the splitting criterion applied. The ranking of variable importance lead to the conclusion that the body weight of the calves, subsequent lactation, husbandry system, gestation length and the sex of the calf are the most significant factors differentiating calving ease. The research showed that stillbirths were diversified only by the body weight of the calves. The present research demonstrates that a graphic model of classification tree can prove a useful tool in distinguishing the factors responsible for calving. It also makes it possible to clearly indicate the factors affecting calving ease and stillbirths that a farmer may observe. [Copyright &y& Elsevier]

This study was designed to analyse the evolution in the use of beef bull semen for dairy cattle insemination and, mainly, to assess calving difficulty, gestation length and proportion of stillbirths after breeding pure Holsteins or crossbreeding. Data were collected during 2004 to 2011 for 552 571 Holstein calvings (457 070 Holstein × Holstein, 43 384 Holstein × Limousine, 32 174 Holstein × Belgian Blue and 19 943 Holstein × Galician Blonde). The highest calving difficulty, compared with pure Holsteins was for crosses with Belgian Blue followed by Limousine and Galician Blonde. The Holstein × Limousine and Holstein × Galician Blonde crossbred calves had significantly longer gestation lengths than Holstein × Holstein and Holstein × Belgian Blue calves. Between the latter two, pure Holstein had the shortest gestation length. Calving difficulty and gestation length decreased as the age of the dam advanced. The most difficult calvings were observed in twin calvings, followed by the calvings of male calves and female calves. The gestations leading to the birth of male calves were longer than those leading to female calves and twin calves. Stillbirths were not related to the breed used for mating. Through examining these parameters, sire breed should be considered when selecting a beef breed for the insemination of milk-producing dams. [ABSTRACT FROM PUBLISHER]

Each year, 814,000 neonatal deaths and 1.02 million stillbirths result from intrapartum-related causes, such as intrauterine hypoxia. Almost all of these deaths are in low- and middle-income countries, where women frequently lack access to quality perinatal care and may delay care-seeking. Approximately 60 million annual births occur outside of health facilities, and most of these childbirths are without a skilled birth attendant. Conditions that increase the risk of intrauterine hypoxia—such as pre-eclampsia/eclampsia, obstructed labor, and low birth weight—are often more prevalent in low resource settings. Intrapartum-related neonatal deaths can be averted by a range of interventions that prevent intrapartum complications (eg, prevention and management of pre-eclampsia), detect and manage intrapartum problems (eg, monitoring progress of labor with access to emergency obstetrical care), and identify and assist the nonbreathing newborn (eg, stimulation and bag-mask ventilation). Simple, affordable, and effective approaches are available for low-resource settings, including community-based strategies to increase skilled birth attendance, partograph use by frontline health workers linked to emergency obstetrical care services, task shifting to increase access to Cesarean delivery, and simplified neonatal resuscitation training (Helping Babies BreatheSM). Coverage of effective interventions is low, however, and many opportunities are missed to provide quality care within existing health systems. In sub-Saharan Africa, recent health services assessments found only 15% of hospitals equipped to provide basic neonatal resuscitation. In the short term, intrapartum-related neonatal deaths can be substantially reduced by improving the quality of services for all childbirths that occur in health facilities, identifying and addressing the missed opportunities to provide effective interventions to those who seek facility-based care. For example, providing neonatal resuscitation for 90% of deliveries currently taking place in health facilities would save more than 93,000 newborn lives each year. Longer-term strategies must address the gaps in coverage of institutional delivery, skilled birth attendance, and quality by strengthening health systems, increasing demand for care, and improving community-based services. Both short- and long-term strategies to reduce intrapartum-related mortality should focus on reducing inequities in coverage and quality of obstetrical and perinatal care. [Copyright &y& Elsevier]

The annual global burden of stillbirths amounts to an estimated 3.2 million%, 98% of which occur in low- and middle-income countries (LMICs). Of these, 1.02 million (32%) are intrapartum, ie, taking place during labor. The most important causes of stillbirths in LMICs include obstructed or prolonged labor, hypertensive diseases of pregnancy, syphilis and gram-negative infections, malaria in endemic areas, and undernutrition. Interventions that target these causes can play an important role in reducing stillbirths. There is a clear benefit of emergency obstetrical care, particularly Cesarean delivery, on intrapartum rates in LMICs when Cesarean rates are less than 8% to 10%. Provision of a skilled birth attendant is another important intervention whereby labor complications can be prevented, identified, managed, and/or referred. Among interventions for infections, syphilis screening and treatment can prevent as many as 50% of all stillbirths in areas with high syphilis prevalence, reducing the risk of stillbirths among treated women to that of untreated women. Intermittent preventive treatment of malaria and insecticide-treated mosquito nets are also interventions with strong recommendation, especially in the first 2 pregnancies. Balanced energy protein supplementation is an important nutritional intervention to prevent stillbirths in undernourished women, especially in LMICs. Creation of increased demand for health services within communities and increasing their uptake also can play a role in averting stillbirths. Other potential social and behavioral interventions include birth spacing, smoking cessation and indoor air pollution control, although the evidence for these is weak. [Copyright &y& Elsevier]

Abstract: Background: Some of the perinatal deaths are preventable. Aims: To examine with accuracy perinatal deaths and their clinically relevant conditions to further reduce perinatal mortality rates. Study design: Population-based study. Subjects: 356 perinatal deaths in Miyazaki Prefecture from 1998 to 2005. Outcome measures: Causes and clinically associated risk factors of perinatal deaths in infants with congenital abnormalities and those of the non-malformed infants. Methods: We performed a population-based study of 87,593 deliveries in Miyazaki from 1998 to 2005, where 356 perinatal deaths were reported. We also held peer-review audit conference twice a year to investigate causes and clinically associated risk factors of the perinatal deaths, where at least 7 obstetricians and 7 neonatologists congregated. Results: Our perinatal mortality rate was 4.1/1000. 99% of the neonatal deaths and 85% of the stillbirths were examined by the peer-review audit conferences to validate the accuracy of causes. Three fourths were non-malformed perinatal deaths, in which stillbirths represented twice the number of neonatal deaths. Prematurity is the major factor attributable to neonatal deaths. Half of stillbirths were unexplainable but associated with overt or subtle fetal growth restriction. Intrapartum asphyxia after 32 weeks of gestation resulted in 10% of perinatal deaths. The audit conferences concluded that 13% (28/222) of the non-malformed infants had a potential of avoiding death. Conclusion: In the advanced region of perinatal medicine in Japan, we still have room to improve perinatal mortality. Most prevalent factors were fetal growth restriction, intrapartum asphyxia after 32 weeks of gestation, and sudden fetal deaths of undiagnosed diabetes near-term. [Copyright &y& Elsevier]

Abstract: Rates and severity of meconium staining on skin and meconium aspiration into the respiratory tract of porcine intrapartum stillbirths were determined in an intensively managed farm. Heartbeats, inspiratory efforts and umbilical cord morphology were evaluated at birth. The lungs of all intrapartum stillborn piglets were grossly examined and microscopically evaluated for the presence of amniotic fluid cells, meconium and inflammatory cells. Thirty four percent of the intrapartum stillbirths had ruptured umbilical cords. Heartbeats and inspiratory efforts were rarely detectable. All intrapartum stillbirths (100%) were stained with meconium, and 60% had meconium grossly visible in the oropharynx and 40% in trachea and bronchi. Microscopically, 72% of the lungs contained meconium. The most common site where meconium was found was the bronchi (66%) followed by bronchioles (48%), and alveoli (34%). There was no microscopic evidence of inflammation in lungs with meconium aspiration. No significant association was found between the severity of skin staining and the degree of meconium aspiration. It was concluded that meconium staining is consistently present in intrapartum stillbirths suggesting that severe hypoxia takes place during parturition. However, meconium staining appears to be a poor predictor for intrapartum aspiration in stillbirth piglets. These findings also suggest that intrapartum death due to asphyxia occurs rapidly thus providing insufficient time in the stillborn to mount a typical inflammatory response in the lung. [Copyright &y& Elsevier]

Natural herbs are being explored as alternatives to antimicrobials. The objective of the present study was to determine the effect of strategic addition of oregano to prefarrowing and lactation diets of sows under field conditions. Alternate farrowing groups were given diets containing 1000 ppm oregano (dried leaf and flower of Origanum vulgare, enriched with 500 g/kg of cold-pressed essential oils of O. vulgare) in prefarrowing and lactation diets. Overall, 801 oregano-treated sows, including 601 primiparous and 1200 multiparous (parity 2.99 ± 0.43, mean ± S.E.) and 1809 untreated control sows (705 primiparous and 1104 multiparous; parity 3.04 ± 0.38), were used. Sows fed oregano had lower annual sow mortality rate (4.02 ± 0.4% versus 6.92 ± 1.11%, mean ± S.E.; P = 0.003), lower sow culling rate during lactation (8.01 ± 1.11% versus 14.02 ± 1.33%, P = 0.02), increased farrowing rate (77.02 ± 2.31% versus 69.91 ± 2.32%, P = 0.01), increased number of liveborn piglets per litter (10.49 ± 1.5 versus 9.95 ± 1.22, P < 0.05), and decreased stillbirth rate (0.909 ± 0.01 versus 0.807 ± 0.01, P = 0.05). In addition, multiparous sows fed oregano had higher (P = 0.04) daily voluntary feed intake compared to non-treated sows (7.7 ± 0.32 kg versus 7.0 ± 0.42 kg, P = 0.04). Additional studies are needed to elucidate the effects of oregano on the gastrointestinal, immune and urogenital system in swine and to determine if it has any adverse effects. [Copyright &y& Elsevier]

Presents abstracts of research on dairy crossbreeding. "Comparison of the Fertility of Pure Holstein Sires and F1 Jersey x Holstein Sires Mated to Pure Holstein Cows in an Experimental Herd," by K. Weigel and C. Maltecca; "Effect of Holstein Females Carrying Holstein Versus Jersey Sired Calves on Subsequent MEMilk, Days Open and Involuntary Culling," by A. J. Seykora et al; "Overview of Different Breeding Objectives in Various Countries for Holsteins," by F. Miglior.

Presents abstracts of research on dairy crossbreeding. "Comparison of the Fertility of Pure Holstein Sires and F1 Jersey x Holstein Sires Mated to Pure Holstein Cows in an Experimental Herd," by K. Weigel and C. Maltecca; "Effect of Holstein Females Carrying Holstein Versus Jersey Sired Calves on Subsequent MEMilk, Days Open and Involuntary Culling," by A. J. Seykora et al; "Overview of Different Breeding Objectives in Various Countries for Holsteins," by F. Miglior.

Objective: Evaluation of causes of death in stillborn infants. Methods: During a five-year period, 310 consecutive autopsies of stillborn infants were performed using a standardized protocol with systematic examination of all major cranial, thoracic and abdominal organs including microscopic examination. Results: In 71%, the intrauterine death (ID) occurred up to the end of the 37th week of gestation. Thirty-seven percent (115/310) stillbirths represented with maceration and about one-half with minor or major malformations. Thirty-one percent (53/171) of them were responsible for intrauterine death. In 83% (44/53), the intrauterine death of the malformed fetus occurred before the end of 37th week of gestation, most of them (48/53, 90.6%) were small for gestational age infants. In 75.5% (234/310), the placental villous tree and the umbilical cord represented pathologic conditions. In 191cases (61.1%), utero-placental pathology was responsible for intrauterine death. Intrauterine infections and traumatic lesions were accompanied by intrauterine death in 2.2 and 1.3%, respectively. In 15.2%, unexplained intrauterine death (because of severe maceration, the placenta was not available for autopsy or insufficient clinical data) occurred. Conclusions: Perinatal autopsy may be valuable in three ways: the confirmation of ante-mortem diagnoses; the identification of unexpected disorders; and exclusion of other (perhaps inheritable) conditions which might be have caused the intrauterine death. Clinically valuable information, obtained from the autopsy, can be improved by high autopsy rate and performing perinatal necropsies by specially trained pathologists. [Copyright &y& Elsevier]