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Objective: To investigate primiparous women's knowledge, attitudes, and practices regarding the physical home food environment (PHFE) and to assess if the first pregnancy provides a teachable opportunity to enhance the PHFE of first-time pregnant couples. Design: Longitudinal in-depth qualitative study involving questionnaires and individual interviews during and after pregnancy. Participants: Fifteen primigravida women. Main outcome measures: Knowledge, attitudes, and behaviors concerning PHFE; lifestyle and dietary habits; and interest in guidance regarding healthy PHFE during the first pregnancy and the transition to motherhood. Analysis: Thematic analysis for qualitative data and descriptive statistics. Results: Key findings include the significance of health, nutrition, and spousal support in the transition to motherhood. The first pregnancy was recognized as a critical period for establishing a healthy PHFE, while noting the physical and emotional challenges involved. A gap was found in guidance regarding PHFE for first-time pregnant women despite their interest in practical advice. Conclusions and Implications: The first pregnancy presents a significant opportunity to improve PHFE. 'Nestrition' (nutritional nesting), a new health-promotion strategy, incorporates nutrition education to enhance this process. These data support future research encompassing partners and diverse at-risk populations prior to the development of effective nutrition education for PHFE in the first pregnancy. [ABSTRACT FROM AUTHOR]

Copyright of Revista Electrónica de Psicología Iztacala is the property of Facultad de Estudios Superiores Iztacala and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: Female calves are the future, in terms of production, in every Holstein herd. Therefore, optimum rearing enhances productivity. Rearing dairy heifers involves important aspects of their early life that can affect their future efficiency. One of these key issues is nutrition management. Appropriate nutrition management impacts genetic performance, calf growth, and future productive and reproductive outcomes, as has been previously demonstrated in the literature. Traditionally, the recommended feeding strategies for dairy calves stipulate two daily milk replacement meals in a restricted diet. However, studies regarding feeding times point out different results in terms of efficiency, growth, and health in Holstein calves. We studied the effect of increasing feeding times (three instead of two per day) but with the same amount of milk replacer daily. Moreover, we included a supplementation of calcium gluconate to study its impact on growth, health, and productive and reproductive indexes in calves. We aimed to enhance welfare and digestive health early in life, expecting to induce positive medium- and long-term effects in the heifers. In fact, we observed a "catch-up" in the growth of calves since weaning, where supplementation with calcium gluconate appeared to reduce animal metabolic stress. We indeed observed a decreasing trend in the number of artificial inseminations per pregnancy, by 0.2 points, in heifers fed with milk replacer thrice daily. Finally, we confirmed significant correlations between early health and growth and reproductive efficiency. Although the medium- and long-term effects of these novel strategies were relatively weak, these management schemes seem to be promising for heifer rearing. We compared the effects of milk-feeding in 288 Holstein calves (72 per group) which were fed twice (2F) or thrice (3F) daily, with or without the addition of hydrogenated fat-embedded calcium gluconate (G) supplemented in the starter food and in the daily diet up to the age of 9 months, on the calves' metabolism, growth, health, and reproductive efficiency up to first pregnancy. The calves received 6 L of milk replacer (130 g/L) and had ad libitum access to water and textured calf starter with or without gluconate. Gluconate supplementation promoted a "catch-up" in growth in supplemented calves compared to their counterparts that did not receive gluconate. Gluconate appeared to reduce animal metabolic stress during key events, such as weaning and transfer into open-door pens, reducing fructosamine (352.61 vs. 303.06 in 3FG and 3F, respectively; p = 0.028) and urea (3F revealed the highest values compared with the other three groups: 19.06 for 3F vs. 13.9 (2F), 13.7 (2FG), and 14.3 (3FG), respectively, p = 0.002) from weaning onwards. The feeding of dairy calves with milk replacer three rather than two times per day tended to be associated with better health from weaning to 4 months old; parameters such as ultrasound lung score and calf health score improved over time (p < 0.001). Thrice-daily feeding with milk replacer tended to reduce the number of artificial inseminations per pregnancy in heifers by 0.2 points (p = 0.092). We confirmed significant correlations between early health and growth parameters and reproductive efficiency and a positive correlation between body weight and average daily weight gain and the thickness of the back fat layer in young heifers (r = 0.245; p < 0.0001; r = 0.214; p < 0.0001 respectively). Our study was conducted on a commercial farm with reasonably effective animal management, so baseline welfare was likely satisfactory. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study is to investigate the effectiveness of the cervical consistency index measured by ultrasonography in predicting the success of labor induction and to apply a more objective and painless method instead of the Bishop score. Methods: A total of 230 primiparous pregnant women were included in our study. Initial Bishop scores, cervical lengths, cervical consistency index measurements, and delivery type of the patients were recorded. Those who responded to induction and delivered vaginally and those who did not respond and gave birth by cesarean section were compared. p value <0.05 was considered statistically significant. Results: There was no significant cut-off value for CCI parameter (p=0.052) and CL parameter (p=0.890) in predicting successful labor induction in first pregnancies. A significant cut-off value was found for the Bishop parameter (p=0.007). A statistically significant negative and weak correlation was found between Bishop score and CL (r=- 0.328; p<0.001). There was no statistically significant relationship between other parameters (p>0.05). Conclusion: Measurement of cervical length and cervical consistency index with transvaginal ultrasound in first pregnancies did not find statistically significant results in predicting the success of labor induction. [ABSTRACT FROM AUTHOR]

Objective: To evaluate potential risk factors for retained placenta in a first pregnancy. Method: This retrospective case–control study included all primigravida with a singleton, live, vaginal birth at 24 weeks or later, at a tertiary hospital, 2014–2020. The cohort was divided into those with retained placenta versus controls. Retained placenta was defined as the need for manual extraction of the placenta or portions of it, immediately postpartum. Maternal and delivery characteristics, and obstetric and neonatal adverse outcomes, were compared between groups. Multivariable regression was performed to reveal potential risk factors for retained placenta. Results: Among 10 796 women, 435 (4.0%) had retained placenta and 10 361 (96.0%) controls did not. Multivariable logistic regression revealed nine potential risk factors for retained placenta: abruption (adjusted odds ratio [aOR] 3.58, 95% confidence interval [CI] 2.36–5.43), hypertensive disorders (aOR 1.74, 95% CI 1.17–2.57), prematurity (<37 weeks, aOR 1.63, 95% CI 1.13–2.35), maternal age older than 30 years (aOR 1.55, 95% CI 1.27–1.90), intrapartum fever (aOR 1.48, 95% CI 1.03–2.11), lateral placentation (aOR 1.39, 95% CI 1.01–1.91), oxytocin administration (aOR 1.39, 95% CI 1.11–1.74), diabetes mellitus (aOR 1.35, 95% CI 1.01–1.79), and female fetus (aOR 1.26, 95% CI 1.03–1.53). Conclusion: Retained placentas in first deliveries are associated with obstetric risk factors, some of which could be related to abnormal placentation. Synopsis: Retained placenta in a first delivery is associated with obstetric and intrapartum risk factors; abnormal placentation is a possible underlying mechanism of this complication. [ABSTRACT FROM AUTHOR]

We compared the effects of milk-feeding in 288 Holstein calves (72 per group) which were fed twice (2F) or thrice (3F) daily, with or without the addition of hydrogenated fat-embedded calcium gluconate (G) supplemented in the starter food and in the daily diet up to the age of 9 months, on the calves’ metabolism, growth, health, and reproductive efficiency up to first pregnancy. The calves received 6 L of milk replacer (130 g/L) and had ad libitum access to water and textured calf starter with or without gluconate. Gluconate supplementation promoted a “catch-up” in growth in supplemented calves compared to their counterparts that did not receive gluconate. Gluconate appeared to reduce animal metabolic stress during key events, such as weaning and transfer into open-door pens, reducing fructosamine (352.61 vs. 303.06 in 3FG and 3F, respectively; p = 0.028) and urea (3F revealed the highest values compared with the other three groups: 19.06 for 3F vs. 13.9 (2F), 13.7 (2FG), and 14.3 (3FG), respectively, p = 0.002) from weaning onwards. The feeding of dairy calves with milk replacer three rather than two times per day tended to be associated with better health from weaning to 4 months old; parameters such as ultrasound lung score and calf health score improved over time (p < 0.001). Thrice-daily feeding with milk replacer tended to reduce the number of artificial inseminations per pregnancy in heifers by 0.2 points (p = 0.092). We confirmed significant correlations between early health and growth parameters and reproductive efficiency and a positive correlation between body weight and average daily weight gain and the thickness of the back fat layer in young heifers (r = 0.245; p < 0.0001; r = 0.214; p < 0.0001 respectively). Our study was conducted on a commercial farm with reasonably effective animal management, so baseline welfare was likely satisfactory.

Background and Aim: Fetal Movement counting is an important measure helps in early identification of fetal wellbeing. This study aimed to determine the maternal and fetal attachment among primi and multigravida women and find their association with baseline variables. Materials and Methods: Study was conducted in a selected Hospital of Mangaluru in the antental OPD from february to march 2020. The study included 80 women in the age group of 20-40 years and 32-38 weeks of gestation. Study group was divided as primigravida and multigravida women. Paired and unpaired t test was used to assess the difference between the prenatal attachment score. Results: No significant difference observed among primi and multgravida women. Also no association was found with baseline variables. Conclusion: There is no difference with prenatal attachment observed between primigravida and multigravida women which concludes that attachment towards the growing fetus is not dependent on gravida status. [ABSTRACT FROM AUTHOR]

Background and Aim: Fetal Movement counting is an important measure helps in early identification of fetal wellbeing. This study aimed to determine the maternal and fetal attachment among primi and multigravida women and find their association with baseline variables. Materials and Methods: Study was conducted in a selected Hospital of Mangaluru in the antental OPD from february to march 2020. The study included 80 women in the age group of 20-40 years and 32-38 weeks of gestation. Study group was divided as primigravida and multigravida women. Paired and unpaired t test was used to assess the difference between the prenatal attachment score. Results: No significant difference observed among primi and multgravida women. Also no association was found with baseline variables. Conclusion: There is no difference with prenatal attachment observed between primigravida and multigravida women which concludes that attachment towards the growing fetus is not dependent on gravida status.

Postponement of first birth has implications for the health and well-being of women and is often associated with lower fertility levels, a demographic reality affecting most high-income countries. Country-level institutional differences are one factor behind the variation in fertility in these countries. This paper examines the relationship between housing and mean age at first birth across 39 low-fertility countries. Using newly compiled indicators of multiple dimensions of the housing context we explore housing from the perspective of renters and homebuyers and examine differences for former-communist and non-former-communist countries. We use six indicators of the housing context and combine them into three different indexes: renter support index, homebuyer support index, and a combined index of both dimensions. Analyses show that access to housing is associated with age at first birth, but that this relationship has changed over time and is different for former-communist and non-former-communist countries. Findings support theories that expectations regarding the importance of homeownership for family formation are changing. [ABSTRACT FROM AUTHOR]

The problem of women's pregnancy anxiety is important to study because it is not only related to pregnant women but also closely related to the fetus they are carrying. This article aims to show whether surah al-Fatihah-based spiritual guidance can be a solution for pregnant women experiencing anxiety. The paper discusses how to operationalize surah al-Fatihah-based guidance for pregnant women, how pregnant women can internalize and carry out an action plan to overcome anxiety, and how to evaluate and repeat the understanding and internalization of surah al-Fatihah through prayer. The article relies on the power of experimental research, in which data is collected through in-depth interviews and qualitatively analyzed with interactive models. The results showed that surah al-Fatihah-based guidance and counseling did not directly address anxiety problems but were able to stimulate pregnant women to carry out various activities consistently, which could reduce anxiety. The current study recommends that counselors and psychologists make it an alternative service in helping clients with psychological and spiritual problems. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to find out the incidence, etiology, and risk factors, define clinical features, show the magnetic resonance imaging (MRI) and laboratory findings, and share the experience of treatment and clinical outcome of pregnancy-related sacral stress fractures (SSFs). Methods: In total, 29,291 (15,008 of them vaginal and 14,283 of them cesarean section delivery) women gave birth in our hospital between January 2016 and December 2021. Twenty-three of them (0.078%) who had low back and pelvic pain were diagnosed with SSFs using pelvic MRI. Dual-energy X-ray absorptiometry (DEXA) was used to rule out underlying osteopenia and osteoporosis and determine the type of SSFs. Results: The incidence of pregnancy-related SSFs was 0.078% (23/29,291patients). Six patients (26%) experienced pain during the last trimester of pregnancy, remaining seventeen (74%) patients had pain during the postpartum period. 73.91% of the patients were primigravida. Thirteen patients (56.52%) were classified as fatigue SSFs, eight (34.78%) were insufficiency SSFs, and only two (8.7%) were defined as a mixed type of SSFs. MRI imaging showed that nine patients (39.13%) had a left-sided fracture, seven patients (30.43%) had a right-sided fracture, and seven patients (30.43%) had bilateral fractures. Vitamin D deficiency (less than 20 ng/mL) was detected in seven patients (30.44%). One case had hypothyroidism in which thyroid stimulating hormone (TSH) was 5.41 μIU/mL. Conclusion: Pregnancy-related SSFs are uncommon but should be considered by clinicians in the differential diagnosis of low back and pelvic pain during pregnancy and the postpartum period. We determined that first pregnancy is a risk factor for SSFs. The current study also revealed that laboratory investigation of vitamin D deficiency and DEXA investigation, which may lead to osteoporosis or osteopenia, were crucial in the diagnosis. Furthermore, some SSFs should be reclassified as mixed fractures, fatigue, and insufficiency fractures. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the fear of childbirth, well-being and partner support in first-time pregnant women. METHODOLOGY: This Cross-sectional study included 100 participants selected by purposive sampling. The sample was collected from two Hospitals in Lahore (Lady Wallington Hospital and Hameed Lateef Hospital) from June to October 2019. Wijma Delivery Expectancy Questionnaire, Wellbeing in Pregnant Women Questionnaire and Partner Support Questionnaire was used to collect data. Analysis was completed using SPSS version 23. Pearson correlation was used to assess the relationship between study variables. An Independent sample t-test was used to compare study variables, and simple linear regression analysis was calculated to predict fear of childbirth on their perception of partner support. RESULTS: 62% of first-time pregnant women showed fear of childbirth. Women who had more fear of childbirth had a low level of well-being (p<0.001). Partner support was significantly negatively correlated with fear of childbirth while positively correlated with well-being (r = .48, p < .001). CONCLUSION: Women with first pregnancy suffer from fear of childbirth. However, partner support is essential to overcome this fear and help increase first-time pregnant women's well-being. [ABSTRACT FROM AUTHOR]

Study objective: to determine the most important maternal factors for the pre-eclampsia (PE) prediction, which are used in screening of women when registered for pregnancy. Materials and methods. A prospective cohort study included 91 pregnant women in their first trimester; study period 2018–2020. The main group included 56 (61.54%) women with a number of maternal factors for PE development, and 35 (38.46%) were healthy females in the control group. Subgroups of women formed for females with and without PE – 28.57% and 71.43%, respectively. Results. Statistically significant values in the study of maternal factors were observed between subgroups of patients with and without PE for body mass index (BMI) prior to pregnancy (26.83 ± 1.29 and 26.03 ± 1.05) and height of pregnant women (163.35 ± 1.26 cm and 167.23 ± 1.02 cm), p 35 years was associated with PE (p = 0.008). During IVF PE developed in combination with such factors as BMI 30 kg/m2 and the interval between pregnancies over 10 years, 1.1% females had no other factors. History of renal disease and the age >35 years had an impact on the PE development in patients with anti-phospholipid syndrome. Analysis of the odds ratio of the isolated maternal factor showed the following indicators: PE during previous pregnancy – 6, multiple pregnancy – 2.56, anti-phospholipid syndrome – 2.56, first pregnancy – 1.83, in vitro fertilization – 1.72, obesity >30 kg/m2 – 1.65, PE in the mother – 1.57, age >35 years – 1.08, history of renal disease – 1, interval between pregnancies >10 years – 0.77 and chronic hypertension – 0.18. Conclusion. Thorough monitoring of maternal risk factors for PE should focus on PE during previous pregnancy. The second position is occupied by multiple pregnancy and anti-phospholipid syndrome. PE risk is increased for a combination of factors, especially with chronic renal disease and/or elevated BMI.

Copyright of Revista Electrónica de Psicología Iztacala is the property of Facultad de Estudios Superiores Iztacala and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objectives Women's nutritional status is important for their health and reproductive fitness. In a population where early marriage is common, we investigated how women's nutritional status is associated with their age at marriage (marking a geographical transfer between households), and at first pregnancy. Methodology We used data from a cluster-randomized control trial from lowland Nepal (n  = 4071). Outcomes including body mass index (BMI) were measured in early pregnancy and trial endpoint, after delivery. We fitted mixed-effects linear and logistic regression models to estimate associations of age at marriage and age at pregnancy with outcomes, and with odds of chronic energy deficiency (CED, BMI <18.5 kg/m2), at both timepoints. Results BMI in early pregnancy averaged 20.9 kg/m2, with CED prevalence of 12.5%. In 750 women measured twice, BMI declined 1.2 (95% confidence interval 1.1, 1.3) kg/m2 between early pregnancy and endpoint, when CED prevalence was 35.5%. Early pregnancy was associated in dose-response manner with poorer nutritional status. Early marriage was independently associated with poorer nutritional status among those pregnant ≤15 years, but with better nutritional status among those pregnant ≥19 years. Conclusions and implications The primary determinant of nutritional status was age at pregnancy, but this association also varied by marriage age. Our results suggest that natal households may marry their daughters earlier if food insecure, but that their nutritional status can improve in the marital household if pregnancy is delayed. Marriage age therefore determines which household funds adolescent weight gain, with implications for Darwinian fitness of the members of both households. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyze the risk factors associated with the development of placenta praevia (PP) in first-time pregnant patients and to observe the perinatal clinical outcomes of patients.MethodsThe clinical data of 112 pregnant women with PP (PP group) and 224 pregnant women with normal placental position (general group) who delivered in our hospital from August 2016 to August 2021 were retrospectively analyzed. Baseline demographic data such as age, gestational week, uterine history, assisted reproductive technology use, pregnancy comorbidities, pre-pregnancy body mass index (BMI), smoking, alcohol consumption, placental position, educational level, work were collected from both groups, and logistic regression models were used to analyze the factors influencing the occurrence of PP in patients with first pregnancy. Perinatal outcomes such as implementation of hemostatic treatment (uterine balloon compression, arterial ligation, and B-Lynch suture), maternal postpartum related indicators (amount of postpartum bleeding, incidence of postpartum hemorrhage, blood transfusion rate, blood transfusion volume, and length of hospital stay), and neonatal condition (birth weight, Apgar score at 1 and 5 min after birth) were counted and compared between the two groups.ResultsHistories of endometriosis, use of assisted reproductive technology, and smoking or secondhand smoke inhalation were all high risk factors for PP in patients with first pregnancies, and the proportion of maternal and neonatal adverse outcomes was significantly higher in the PP group than in the general group (P < 0.05).ConclusionHistories of endometriosis, smoking (secondhand smoke), and use of assisted reproductive technologies are independent risk factors for PP in patients with first pregnancies, which can increase the risk of labor and death of the newborn.

Pregnancy is a dynamic process associated with significant and thorough hormonal and hemodynamic changes that directly or indirectly influence cardiac function. However, the effect of these alterations on left ventricular myocardial contractile function has not been fully illustrated. So, in this study we use speckle tracking echocardiography, which is a novel modality used for the assessment of mechanical myocardial function (strain) and strain rate. To assess the maternal left ventricular function during the third trimester of first pregnancy using speckle tracking echocardiography. This cross sectional study was carried out in Baghdad teaching hospital in the time period from October 2020 to May 2021. A total of 108 women were studied and 100 of them were included, they were classified into two groups: 50 non pregnant women with mean age (24.6 ±3.80 year) served as control group, and 50 pregnant women with normal singleton pregnancy (30-40 weeks of gestation) with mean age (23.6±2.83 year) served as study group. The left ventricular systolic function was assessed using transthoracic echocardiography to measure LV ejection fraction EF%. Furthermore, the left ventricular contractile function evaluated with speckle tracking echocardiography (STE) by measuring LV global longitudinal strain (GLS). The left ventricular ejection fraction shows no significant difference between pregnant and control group (p= 0.214), while the left ventricular global longitudinal strain (GLS) shows significant decrease in the pregnant females in their third trimester (p= 0.001). In conclusion, left ventricular global longitudinal strain (GLS) shows significant reduction during the third trimester of normal first pregnancy. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Prenatal care is an important strategy for achieving reproductive health. Despite the importance of maternity care in maternal health, some mothers are not adequately cared for. The aim of this study was to determine the factors affecting the Adequacy of Prenatal Care Utilization (APNCU) Index in the first level of network system in Iran. METHODS: This cross-sectional study was conducted in six provinces of Iran in 2016. Mothers whose date of delivery was 2-6 months before the study were randomly selected. Data were collected using a researcher-made checklist and questionnaire containing 34 personal, family-related and environmental questions and 23 prenatal care-related questions based on health records and interviews with mothers and samples were divided into four groups according to the Adequacy of Prenatal Care Utilization index: 1: inadequate (less than 50% of expected care), 2: intermediate (50-79%), 3: adequate (80-109%), 4: adequate plus (110% and more), and the results were analyzed. FINDINGS: Among 2655 studied mothers, the mean of total care during pregnancy was 6.43±1.7 times and according to the Adequacy of Prenatal Care Utilization index, 121 (4.6%) mothers had inadequate care, 603 (22.7%) mothers had intermediate, 1648 (62.1%) mothers had adequate and 283 (10.7%) mothers had adequate plus care. There was a significant relationship between the risk of maternal mortality in each province, urban population, prenatal care, time of first pregnancy care, maternal age, spouse's participation and education level, and adequacy of prenatal care (p<0.05). CONCLUSION: This study showed that the adequacy of prenatal care, although influenced by social and personal factors, is at an appropriate level. [ABSTRACT FROM AUTHOR]

Background: Women are more likely to develop post-traumatic stress disorder (PTSD) than men. Limited research exists evaluating the risk of hypertensive disorders of pregnancy (HDP) among military women with PTSD.Methods: We conducted a retrospective cohort study using US Department of Defense (DoD) data comprised of all active-duty women giving birth to their first, liveborn singleton infant using DoD-sponsored health insurance from 1 January 2004 to 31 December 2008 (n = 34 176). Birth hospitalisation records, maternal mental health visits, and Post-Deployment Health Assessment (PDHA) and Reassessment (PDHRA) screenings were included. The HDP outcome (yes vs no) was defined using ICD-9-CM codes in the maternal birth hospitalisation record. Women fit into one of four PTSD exposure categories (confirmed, probable, possible, none). Confirmed cases had a PTSD ICD-9-CM diagnosis code. Probable/possible cases were classified using PDHA screening items. We used multiple log-linear regression to assess PTSD (confirmed, any vs none) and the risk of HDP overall, and then explored effect modification by military service and demographic variables. We assessed the risk of HDP among deployed mothers with PTSD (confirmed, probable/possible vs none) who completed a PDHA, and explored effect modification by race/ethnicity. We also assessed risk of HDP with differing PTSD lead times.Results: Overall, PTSD was not associated with HDP except among mothers whose PTSD was diagnosed ≥1 year prior to conception (RR 1.42, 95% CI 1.06, 1.90).Conclusions: Post-traumatic stress disorder preceding conception by at least a year appeared to confer an increased risk of HDP, but further research is needed using more thorough PTSD assessment. [ABSTRACT FROM AUTHOR]

Objective: Increased birthweight is a risk factor for early neonatal complications, as well as cardiovascular and metabolic disease later in adulthood. We aimed to assess birthweight trends and the rate of large for gestational age newborns in women in their third delivery according to birthweight in the first and second deliveries.Study Design: A retrospective cohort study of all women who delivered their first three consecutive deliveries in a single medical center (1994-2013). Only non-diabetic women with term (≥ 37 weeks) singleton deliveries in all three deliveries were included. BW centile (according to local gender- and gestational age-specific birth curves) trends between deliveries was assessed. In addition, the risk for large for gestational age (≥ 90th centile) infants in the third delivery was assessed according to the presence or absence of large for gestational age in previous deliveries. Pregnancies complicated by multiple gestations, preeclampsia, chronic or gestational hypertension or fetal anomalies were excluded.Results: Of the 121,728 deliveries during the study period, 3521 women (10,563 deliveries [8.6%]) met inclusion criteria. Mean birthweight centile in the first, second and third deliveries were 47.2 ± 26.3, 58.3 ± 25.8 and 61.5 ± 24.7, respectively (p < 0.001). While 45.9% women had their maximal birthweight centile in the third delivery, only 16.5% had it in the first delivery (p < 0.001). In multivariate analysis, adjusted for maternal age, gestational age at delivery and neonatal gender, the rate of large for gestational age infants in the third delivery was increased as the number of previous large for gestational age deliveries increased in a dose-dependent pattern (aOR = 4.37, CI  2.89-6.61 for women with large for gestational age infant only in the first delivery, aOR = 5.31, CI   4.15-6.79 for women with large for gestational age infants only in the second delivery, aOR = 10.62, CI  6.89-16.38 for women with large for gestational infants age in the first and second deliveries; women with no large for gestational age infants in both the first and second delivery served as reference group).Conclusion: In women with repeated term deliveries, birthweight centile is frequently increased in the third delivery compared to the previous two deliveries. Moreover, the number and order of previous large for gestational age deliveries in the first two deliveries are major risk factors for large for gestational age in the third delivery. [ABSTRACT FROM AUTHOR]

Women's voice pitch (the perceptual correlate of fundamental frequency, F 0) varies across the menstrual cycle and lowers after menopause, and may represent a putative signal of women's fertility and reproductive age. Yet, despite dramatic changes in women's sex hormone levels and bodies during and after pregnancy, previous between-subject and case studies have not found systematic changes in F 0 due to pregnancy. Here, we tracked within-individual variation in 20 mothers' voices during their first pregnancy, as well as up to 5 years before conception and 5 years postpartum. Voice recordings from 20 age-matched nulliparous women were measured as a control. Linear Mixed Models indicated that F 0 mean, range and variation changed significantly following pregnancy in mothers, controlling for age at time of recording, whereas we did not observe any F 0 changes across corresponding timeframes in our sample of nulliparous controls. Mothers' voices became significantly lower-pitched and more monotonous during the first year postpartum compared to during pregnancy or before. These F 0 parameters did not decrease within-individuals over a 5-year period prior to conception above and beyond the effects of ageing. Although voice pitch decreased following pregnancy, mothers' F 0 parameters reverted after the first year postpartum, approaching pre-pregnancy levels. Our results demonstrate that pregnancy has a transient and perceptually salient masculinizing effect on women's voices. [ABSTRACT FROM AUTHOR]

Introduction: HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) may have specific risk factors and risk factors varying from first to second pregnancy. The aims of the study were to estimate the risk of HELLP syndrome by potential risk factors in first and second pregnancy, respectively.Material and Methods: A population-based cohort study including all women in Norway having their first baby (≥22 gestational weeks) during 1999 to 2014, registered in the Medical Birth Registry (n = 418 897). A subset of women with at least two births (n = 249 070) was used for estimates in second pregnancy. Relative risks with 95% CIs for HELLP syndrome were estimated using logistic regression and adjusted for maternal age and year of childbirth.Results: Body mass index ≥30 kg/m2 and diabetes were associated with HELLP syndrome in first, but not in second pregnancy. Chronic hypertension and multiple pregnancy were associated with HELLP syndrome both in first and second pregnancy. In second pregnancy the strongest risk factors were a history of HELLP syndrome or preterm preeclampsia in the first. The risk was inversely correlated with gestational age at first delivery. The overall relative risk for recurrence of HELLP syndrome was 54.4 (95% CI 34.3-86.2) and 129.5 (95% CI 45.7-367.2) after HELLP syndrome before 29 weeks of gestation in first pregnancy.Conclusions: Important risk factors for HELLP syndrome differ from first to second pregnancy. HELLP syndrome in second pregnancy is rare, but the relative risk is very high in women with HELLP syndrome or preterm preeclampsia in their first pregnancy. [ABSTRACT FROM AUTHOR]

Early motherhood is a major health challenge in most developing countries. The aim of this study was to explore Iranian mothers' experiences of the outcomes of early motherhood. This qualitative study was done using the conventional inductive content analysis approach. A purposive sample of 18 Iranian mothers, with the experience of early motherhood, was recruited with maximum variation in terms of their age at their first pregnancy, their children's age, place of residence, and financial status. Data collection was done via in-depth semistructured interviews and continued up to data saturation. The MAXQDA software (v. 10.0) was employed for handling the data. Iranian mothers' experiences of the outcomes of early motherhood came into two main categories that were named "realization of the childhood dream of adulthood" and "heavy burden of adulthood on the small shoulders of childhood," The four subcategories of the first category were the acceleration of intellectual and mental maturation, strengthening of family relationships, developing a strong identity, and closer companionship with the child. The second main category also included four subcategories, namely, experiencing numerous difficulties, threats to mothers' physical and mental health, threats to children's health, and missing opportunities. Early motherhood is not merely a negative experience; rather it is also associated with different positive outcomes. Healthcare providers need to provide high-quality prenatal, perinatal, and postnatal care services to adolescent mothers and use available opportunities to strongly support them and their children. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: This study aimed to determine the prevalence of urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP) 3-5 years after the first pregnancy and their associated risk factors. Methods: We assessed 506 women using the Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ). Maternal characteristics and obstetric data were analyzed using descriptive analysis, independent sample t test, chi-squared test, and logistic regression. Results: The prevalence of UI, FI, and POP, respectively, at a mean of 43 months after first delivery was 40.8, 6.6, and 10.2% following vaginal delivery (VD) and 22.7, 4.5, and 4.5% following cesarean section (CS). Stress urinary incontinence (SUI) was reported by more women following VD than CS (38.7 vs 22.4%, P = 0.010). Compared with 8 weeks' postpartum, more women reported SUI at this later follow-up visit (40.1 vs 19.5%, P < 0.001), but fewer reported FI. More women who had an instrumental delivery reported symptoms of POP compared with those who had a normal VD. Higher body weight and weight gain from first trimester were risk factors of SUI [odds ratio (OR) 1.03] and urge urinary incontinence (UUI) (OR 1.18), respectively. Women who delivered vaginally had higher PFDI subscales scores. Conclusions: VD increased UI risk. Higher body weight and weight gain from first trimester were risk factors for SUI and UUI, respectively. More women reported symptoms of POP following an instrumental delivery than those who had a normal VD. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of early pregnancy on obstetric fistula.Methods: A prospective observational study was conducted among patients with obstetric fistula caused by a long obstructed labor who presented at Selian Lutheran Hospital, Tanzania, or Kitovu Hospital, Uganda, between January 1, 2015, and January 31, 2016. Demographic and clinical variables were evaluated.Results: Among 270 patients, 162 (60.0%) experienced their first pregnancy up to 2 years after menarche (early group) and 108 (40.0%) experienced their first pregnancy more than 2 years after menarche (late group). No significant differences between the early and late groups were found for median age at presentation (30.0 vs 28.0 years), median parity (both 2.0), stillbirth (n=145 [89.5%] vs n=95 [88.0%]), median duration of labor (both 2.0 days), home delivery (n=31 [19.1%] vs n=17 [15.7%]), cesarean delivery (n=79 [48.8%] vs 58 [53.7%]), median time from obstetric fistula formation to presentation (48.0 vs 24.0 months), and obstetric fistula classifications. Obstetric fistula occurred during the first pregnancy in 99 (61.1%) women in the early group and 71 (65.7%) in the late group (P=0.440).Conclusion: Frequency of obstetric fistula during the first pregnancy is not increased among women who experience their first pregnancy within 2 years of menarche. [ABSTRACT FROM AUTHOR]

Objective: To assess whether women with a history of preterm birth, independent on the presence of prelabour rupture of the membranes (PROM) and growth deviation of the newborn, are more likely to develop preeclampsia with preterm or preterm birth in a subsequent pregnancy. Methods: We conducted a population-based cohort study, based on Medical Birth Registry of Norway between 1967 and 2012, including 742,980 women with singleton pregnancies who were followed up from their 1st to 2nd pregnancy. In the analyses we included 712,511 women after excluding 30,469 women with preeclampsia in the first pregnancy. Results: After preterm birth without preeclampsia in the first pregnancy, the risk of preterm preeclampsia in the second pregnancy was 4–7 fold higher than after term birth (odds ratios 3.5; 95% confidence interval (CI) 3.0–4.0 to 6.5; 95% CI 5.1–8.2). The risk of term preeclampsia in the pregnancy following a preterm birth was 2–3 times higher than after term birth (odds ratios 1.6; 95% CI 1.5–1.8 to 2.6; 95% CI 2.0–3.4). After spontaneous non-PROM preterm birth and preterm PROM, the risk of preterm preeclampsia was 3.3–3.6 fold higher than after spontaneous term birth. Corresponding risks of term preeclampsia was 1.6–1.8 fold higher. No significant time trends were found in the effect of spontaneous preterm birth in the first pregnancy on preterm or term preeclampsia in the second pregnancy. Conclusions: The results suggest that preterm birth, regardless of the presence of PROM, and preeclampsia share pathophysiologic mechanisms. These mechanisms may cause preterm birth in one pregnancy and preeclampsia in a subsequent pregnancy in the same woman. The association was particularly evident with preterm preeclampsia. [ABSTRACT FROM AUTHOR]

Background: Gestational Weight Gain (GWG) below or above the Institute of Medicine (IOM) recommendations increases the risk of adverse pregnancy outcomes. However, it remains unknown whether the risk of adverse outcomes is affected by GWG in a previous pregnancy. We examined associations between GWG in the index (second) pregnancy and pregnancy outcomes, including preterm delivery and small for gestational age (SGA), while taking into consideration GWG in the first pregnancy.Methods: In a population-based cohort study (n = 210 564), using the Missouri maternally-linked birth registry (1989-2005), we used multivariable Poisson regression with robust error variance stratified by prepregnancy body mass index (BMI) to evaluate associations between GWG in the index pregnancy and a composite indicator of GWG in the first and second pregnancies and our outcomes of interest, after controlling for sociodemographic and pregnancy-related confounders.Results: Associations between GWG in the index pregnancy and pregnancy outcomes were moderated by GWG in the first pregnancy. Despite having GWG within recommendations in the index pregnancy, women had increased risk of preterm delivery and SGA if they had suboptimal GWG in their first pregnancy. Also, women having suboptimal GWG in the index pregnancy had increased risk of preterm delivery only if their GWG in the first pregnancy was also suboptimal.Conclusions: The observation that women who have GWG within recommendations in a current pregnancy may still have increased risk of adverse outcomes if they had suboptimal GWG in the first pregnancy has considerable clinical and public health implications. [ABSTRACT FROM AUTHOR]

Objective: To study whether placental weight in the first pregnancy is associated with preeclampsia in the second pregnancy.Study Design: In this population-based study, we included all women with two consecutive singleton pregnancies reported to the Medical Birth Registry of Norway during 1999-2012 (n=186 859). Placental weight in the first pregnancy was calculated as z-scores, and the distribution was divided into five groups of equal size (quintiles). We estimated crude and adjusted odds ratios with 95% confidence intervals for preeclampsia in the second pregnancy according to quintiles of placental weight z-scores in the first pregnancy. The 3rd quintile was used as the reference group.Results: Among women without preeclampsia in the first pregnancy, 1.4% (2507/177 149) developed preeclampsia in the second pregnancy. In these women, the risk for preeclampsia in the second pregnancy was associated with placental weight in the first pregnancy in both lowest (crude odds ratio (cOR) 1.30, 95% confidence interval (CI); 1.14-1.47) and highest quintile (cOR 1.20, 95% CI; 1.06-1.36). The risk associated with the highest quintile of placental weight was confined to term preeclampsia. Among women with preeclampsia in the first pregnancy, 15.7% (1522/9710) developed recurrent preeclampsia, and the risk for recurrent preeclampsia was associated with placental weight in lowest quintile in the first pregnancy (cOR 1.30, 95% CI; 1.10-1.55). Adjustment for interval between pregnancies, maternal diabetes, age, and smoking in the first pregnancy did not alter these estimates notably.Conclusion: Placental weight in the first pregnancy might help to identify women who could be at risk for developing preeclampsia in a second pregnancy. [ABSTRACT FROM AUTHOR]