Postpartum Interval Research Articles

Postponing first colostrum collection: impact on immunoglobulin G in goat colostrum

This experiment was motivated by the need to understand the impacts of delaying the first colostrum collection on immunoglobulin G (IgG) concentrations in goat colostrum, addressing a gap in caprine-specific research, despite its significance in dairy farming. Concurrently, we examined the relationship between colostral IgG, total protein (TP) and Brix values. Two colostrum samples were collected from 56 Saanen goats, one from each udder half. The first sample was collected from the right teat immediately postbirth, and the second sample was collected from the left teat at one of the predetermined postpartum intervals: 0, 4–6, 8–10, or 12–14 h postpartum, each time interval comprising 14 goats. Colostral IgG was determined by ELISA, Brix was determined by digital refractometry, and TP was determined by the Bradford protein method. Sperman’s correlations and Lin’s concordance correlation coefficient were used to determine the direction and strength of the association and to assess agreement (prediction accuracy) between methods, respectively. Receiver operator characteristic analysis was used to determine Brix and TP thresholds for predicting good-quality colostrum using several cut-offs (20, 30, 40, and 50 g/L IgG). Mean (± SD) for colostral IgG, Brix, and TP were 54 ± 22.6 g/L, 22 ± 5.0%, and 12 ± 2.8 g/dL, respectively. The statistical analysis did not provide evidence of a significant impact of time of first collection (up to 14 h postpartum), on IgG, Brix, and TP. Brix and IgG values exhibited both a high degree of correlation (r = 0.89–90) and concordance (ρc = 0.89–90), indicating a strong and reliable relationship between the two measurements. The prevalence of samples ≥ 20, 30, 40, and 50 g of IgG/L were 96, 88, 71, and 54%, respectively. Optimal Brix and TP thresholds predicting IgG ≥ 20, 30, 40, and 50 g/L IgG were 13.8, 17.5, 20.1, and 22.5%, and 6.8, 9.3, 10.8, and 11.1 g/dL, respectively. Increasing the IgG threshold resulted in lower sensitivity but higher specificity for estimating colostral IgG using Brix or TP values. The present findings indicate that delaying the first colostrum collection up to 14 h postpartum did not result in conclusive changes in colostral IgG concentration, Brix values, or total protein levels. Our results also confirm the reliability of Brix refractometry as an on-farm tool for estimating IgG concentrations in goat colostrum. These results are particularly relevant to intensive dairy systems, offering insights to enhance colostrum management and task prioritisation, especially during the bustling kidding periods.

Postpartum glycemic and cardiometabolic profile of women testing positive for gestational diabetes mellitus by International Association of Diabetes and Pregnancy Study Groups (IADPSG) but negative by alternate criteria: Insights from CHIP–F study

ObjectiveTo evaluate burden of postpartum diabetes and other cardiometabolic risk factors among women who test positive for gestational diabetes mellitus (GDM) by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, but negative by alternate criteria. MethodsThis prospective cross-sectional study was conducted from 2019 to 2022 and is a sub-study of the CHIP–F cohort (Cohort Study of Indian Women with Hyperglycemia in Pregnancy and their Families). ResultsStudy participants (n = 826; 183 with normoglycemia and 643 with GDM using IADPSG criteria) were evaluated at a median (IQR) postpartum interval of 31 (21–45) months. Using the United Kingdom National Institute of Health and Care Excellence (UK NICE), Canadian Diabetes Association (CDA), and Diabetes in Pregnancy Study Group India (DIPSI) criteria, 251 (39.0 %), 148 (23.0 %) and 384 (59.7 %) women who tested positive for GDM by IADPSG criteria, would have tested negative. The incidence of postpartum diabetes among such women was 30.4, 34.3, and 48.2 per 1000 women-years, respectively, which was significantly higher than those testing negative by both IADPSG and UK NICE (5.0 per 1000 women-years), IADPSG and CDA (9.2/1000 women-years) and IADPSG and DIPSI criteria (5.0/1000 women-years). The burden of obesity and metabolic syndrome was also significantly higher in such women. ConclusionsWe found a significant burden of postpartum diabetes and cardiometabolic risk factors among women who tested positive for GDM by IADPSG, but negative by alternate criteria. There are potential clinical implications of a “failed” diagnosis for future cardiometabolic diseases that need to be carefully examined.

Evaluation of pregnancy associated glycoproteins assays for on farm determination of pregnancy status in beef cattle.

Transrectal ultrasonography is known as the gold standard for pregnancy detection, but requires costly equipment and technical skills; therefore, access to an inexpensive and more user-friendly method with similar accuracy could benefit cattle producers. Detection of pregnancy-associated glycoproteins can accurately determine pregnancy in ruminants; however, usually requires specialized equipment for the assay. Thus, the objectives of these studies were to 1) validate the IDEXX Alertys OnFarm Pregnancy Test (lateral flow) and compare the accuracy of all three commercial PAG assays to transrectal ultrasonography and 2) to determine the postpartum interval necessary for clearance of pregnancy-associated glycoproteins from the previous pregnancy to avoid false positives. In study 1, blood samples from previously identified pregnant Bos taurus females from six different herds (nulliparous n = 1,205 and multiparous n = 1,539; samples collected between d 27 to 285 of gestation over a three-year period) were utilized. In study 2, postpartum females (primiparous n = 48 and multiparous n = 66) from one herd were utilized: (n = 1,066; samples collected weekly for up to 12 weeks postpartum). In study 1, level of agreement between different methods of pregnancy detection was determined by Pearson's correlation and Kappa scores. In study 2, data were analyzed as a repeated measure using the MIXED procedure of SAS with main effects of parity, days postpartum (dpp), and parity by days postpartum, then data were analyzed further using the REG procedure of SAS. In study 1, transrectal ultrasonography and lateral flow were positively correlated (r = 0.77; P <0.01), with 92.4% agreement. In study 2, the abundance of absorbance of PAGs rapidly decreased from 0 to 50 days postpartum, then continued to gradually decrease (P <0.01; r = 0.90). Prior to 42 days postpartum, PAG concentrations were sufficiently elevated resulting in false positive readings in all assays. In conclusion, there is very good agreement between transrectal ultrasonography and PAG assays, but likelihood of false positive results are highif assays are performed fewer than 42 days postpartum.

REVIEW ON FERTILITY PERFORMANCES OF LOCAL AND CROSSES OF EXOTIC BREED DAIRY CATTLE IN ETHIOPIA.

Review was carried out on fertility or reproductive performances of Ethiopian locals’ cattle and their Friesian and Jersey crosses. The objectives were to review research results on age of puberty, age at first calving, days open, postpartum anestrus interval, Service period, Number of Services per Conception and calving interval. The available review result showed that F1 Jersey and Friesian crosses had 7.65 and 5.89months shorter AFC than their F2 counterparts, respectively. Likewise, these crosses also had 12.63 and 11.35-months shorter AFC than that of local cows, respectively. Crossbred cows having 75% Friesian inheritance had comparable age at first calving with that of F1 Friesian and Jersey crosses. F1 Friesian crosseswere observed to have 37.67 and 33.96 days shorter calving interval as compared to crosses with 75% Frisian inheritances and F2 Friesian crosses, respectively. F1 Friesian and Jersey crosseshad 33.96 and 54.91 days shorter calving interval than their F2 counterparts, respectively. Crossbred cows having 75% Jersey had better reproductive performances than that of other crosses in reproductive traits considered except in age at first calving. Therefore, if the reproductive performance of local cows is to be improved, cows must be genetically upgraded to the level 50% exotic inheritances (Friesian/Jersey). Upgrading local cattle up to 75% exotic inheritance could also be done for better reproductive efficiency provided that the level of management is good enough to meet the relatively higher managerial demand of these animals. F1 crossbred dairy cattle is suitable to be used as dairy cattle under small holder management conditions and crossbred having 75% exotic blood level for urban and peri-urban dairy producers.

Safety and Efficacy of Inferior Vena Cava Filters in the Peri-Partum Period: Experiences at a Tertiary Care Facility

Background: Guidelines recommend placement of inferior vena cava (IVC) filters in patients with acute thrombotic episodes and a concurrent contraindication to anticoagulation, however filter placement during or immediately postpartum presents significant technical challenges. The use and complications of IVC filters in the peripartum period is poorly documented in current literature. Objective(s): To evaluate the use of and outcomes related to IVC filters in an obstetric population at a large tertiary care center. Study Design: Retrospective review of all patients at a tertiary academic medical center from 2001-2016 who either conceived with an IVC filter in place or underwent IVC filter placement during the antepartum or postpartum interval. Manual abstraction of each chart was performed, with data stored in a RedCap database. Results: A total of 24 patients were included in the final analysis: 5 with IVC filter placement prior to pregnancy, 7 with antepartum placement, and 12 with postpartum placement. One patient had multiple pregnancies during our study timeframe and was therefore included twice. The cohort of postpartum placement were the youngest mean age (23.7 years), had a higher number of IVC filters placed for polytrauma (n=4), and had the shortest time to removal (135.9 days). The vast majority (91.3%) of IVC filters placed during pregnancy were retrievable filters in the suprarenal position, while most deployed in an infrarenal position (83.3%) when placed prior to conception. Complications encountered included multiple attempts to remove IVC filter, severe angulation, embedded struts, fracture, and one case of cardiac tamponade during filter placement requiring emergent sternotomy and evacuation. Of the filters requiring multiple attempts for removal, in 1 patient (4%) it was unable to be removed despite multiple attempts and the filter was ultimately left in situ. Complications were more common when placement was performed prior to pregnancy or antepartum (40% and 57.1% respectively) versus postpartum (16.7%). From an obstetrical perspective, 1 patient (4%) required early preterm delivery due to preeclampsia; 1 maternal death occurred in a postpartum patient who experienced a massive pulmonary embolism and subsequently died despite emergent thrombectomy and IVC filter placement, and 1 neonatal death occurred due to congenital heart disease following periviable preterm delivery. Conclusion(s): In our study across 16 years at a large academic medical center we identified 23 patients who had an IVC filter placed prior to pregnancy or placed during the antepartum or postpartum periods. Data from our experience suggested a higher incidence of complications with preconceptual and antepartum placement, although the majority of these did not impact clinical outcomes. While not frequently needed, IVC filters remain an option for clinicians treating pregnant and postpartum patients but should be considered a last resource as they can lead to various complications.

A synonymous single nucleotide polymorphism (g.36417726C > A) in the Lama2 gene influencing fat deposition is associated with post-partum anestrus interval in Murrah buffalo

Postpartum absence of estrus exhibition known as postpartum anestrus interval (PPAI) for more than 90 days after calving is a concerning issue for dairy buffalo farmers' economy. The PPAI duration is influenced by both management practices and animal genetics. Investigating genetic markers associated with PPAI is crucial for incorporating them into marker-assisted selection programs. Towards this goal, our study focused on exploring potential genetic markers from early postpartum adipose tissue gene networks. We successfully identified 24 Single Nucleotide Polymorphisms (SNPs) within 9 candidate genes. In our initial analysis involving 100 buffaloes, we detected a significant association (P = 0.02267) between a specific synonymous SNP within the Lama2 gene (g.36417726C > A) and PPAI. This finding was subsequently validated (P = 0.02937) in a larger cohort of 415 buffaloes, where the SNP explained 1.36 % of the genetic variance. Intriguingly, buffaloes with the CC genotype of this SNP exhibited a PPAI that was 12.71 ± 3.21 days longer compared to buffaloes with AA and CA genotypes. To gain insight into the functional relevance of this SNP, a computational analysis was performed which indicated that the C allele of the SNP (g.36417726C > A) increased the stability of LAMA2 mRNA compared to the A allele. This computational prediction was corroborated by observing a significant increase (P = 0.01798) in Lama2 gene expression (greater than 8-fold) and higher fat percentage (P < 0.05) in adipose tissue of CC genotypes (48.78 ± 1.87 %) compared to AA genotypes (33.59 ± 4.5 %). Furthermore, we noted a significant (P < 0.05) upregulation of C/ebpβ, Pparγ, Fasn, C/ebpα, and Pnpla2 genes, along with the downregulation of Bmp2 and Ptch1 in CC genotypes as opposed to AA genotypes. This observation suggests the involvement of the Pparγ-mediated pathway in both adipogenesis and lipolysis within CC genotypes. In summary, our comprehensive analysis involving association and functional validation underscores the potential of the SNP (g.36417726C > A) within the Lama2 gene as a promising genetic marker against extended PPAI in Murrah buffalo.

Comparison of Complication of Postpartum Intrauterine Contraceptive Device With Interval Placed IUCD

For prevention of unintended and closed interval pregnancies through the first year following childbirth, postpartum family the planning is required. A wide range of reliable and cost-effective contraceptive methods are available for postpartum women. Objective: To compare the frequency of complications of postpartum intrauterine contraceptive device (PPIUCD) versus interval placed intrauterine contraceptive device (IUCD). Methods: It was a randomized control clinical trial which was conducted in Unit 3, Department of Obstetrics &amp; Gynecology, Lady Willingdon Hospital, Lahore. The time period of this study was 6 months extending from January 2018 to June 2018. After fulfilling the inclusion criteria, 160 patients were enrolled in the study. These patients were followed up for time period of 6 months in both groups. The complications named perforation, pelvic infection and expulsion were noted. All the gathered information regarding variables was analyzed on SPSS version 20.0. Results: The mean age and gestational age of females of the PPIUCD group was 26.50±5.05 years and 38.94±1.42 weeks and interval IUCD group was 28.25±4.40 years and 39.08±1.29 weeks respectively. In this study the pelvic infection was noted in 8 females in which 2 were from PPIUCD group and 6 were from interval IUCD group. Statistically insignificant difference was found between the study groups with pelvic infection i.e. p-value=0.147. Expulsion was noted in 1 female from PPIUCD group and 3 females from interval IUCD group. The difference was insignificant (p&gt;0.05). Conclusions: There was no statistical difference found in frequency of complications with PPIUCD versus interval placed IUCD.

Optimum Time of Insemination after Onset of Oestrus in Holstein – Friesian Dairy Cows in the Peri-urban Khartoum (Sudan)

The aim of this study was to determine the optimum time of insemination after onset of oestrus in Holstein-Friesian dairy cows. 146 and 92 Cows were randomly assigned to the control and prostaglandin F2α treated groups respectively. The experimental animals were then visually observed for oestrus for a period of twelve months. 188 and 99 inseminations were given to the control and prostaglandin F2α treated groups respectively. The inseminations were given at time intervals of 1-6, 7-12, 13-18, and 19-24 hours after onset of oestrus during winter, hot dry summer and hot wet summer. During the three seasons, inseminations were carried out in cows at postpartum interval of 41-60, 61-80, 81-100, 101-120, 121 and over days. The trial was conducted in Cows at parities 1 and 2 as a group, and parities 3 and over as a separate group. The optimum time of insemination to achieve the highest conception rates was at 13-18 hours in the control group of Cows. Winter had the highest conception rates compared to other seasons. Cows at postpartum intervals of 121 and over days had the highest conception rates. Conception rates in cows at parities 1 and 2 had the highest conception rate compared to other parities. The present study revealed that the control group of cows had the highest conception rates when inseminations were at 13 – 18 hours after onset of oestrus compared to prostaglandin F2α treated cows.

Cardiometabolic profile of women with a history of overt diabetes compared to gestational diabetes and normoglycemia in index pregnancy: Results from CHIP-F study.

We aimed to evaluate the prevalence of postpartum diabetes among women with a history of overt diabetes in pregnancy (ODiP) and compare with women having a history of gestational diabetes mellitus (GDM) and normoglycemia in pregnancy. We have an established longitudinal cohort of postpartum women with a history of hyperglycemia (preexisting diabetes [PED] [n = 101], ODiP [n = 92], GDM [n = 643]), and normoglycemia (n = 183) in pregnancy. For this study, we excluded women with PED and invited other eligible women in a fasting state for clinical and biochemical evaluation. We evaluated 918 women with a mean (SD) age of 33.6 (5.0) years and at a median (interquartile range) postpartum interval of 31 (20-45) months. Diabetes was diagnosed in 65 (70.7%) women in ODiP compared to 99 (15.4%) in GDM (p < .001) and 4 (2.2%) in normoglycemia group (p < .001). In the ODiP group, the prevalence of diabetes was 47.4% among women tested in the first year postpartum, increasing to 86.8% among women tested at >3 years postpartum. Diabetes was more common when ODiP was diagnosed in the first (27/29, 93.1%) compared to the second trimester of pregnancy (35/57, 61.4%). The adjusted odds ratio for diabetes in ODiP was 14.82 (95% confidence interval, 8.49-25.87; p < .001; reference category: GDM). The prevalence of postpartum diabetes was significantly higher in women with ODiP compared to GDM. Nearly 50% of women with ODiP did not develop diabetes in the first year of follow-up, especially when ODiP was diagnosed after the first trimester of pregnancy and on the basis of a 2-h oral glucose tolerance test value. Such women are amenable to prevention strategies.

Can maternal postpartum testosterone and estradiol retrospectively predict the offspring's sex at birth? A cross-sectional study in Ghana.

The selection of X- or Y-bearing spermatozoa during fertilization may depend on maternal circulating sex hormones. The zona pellucida of the developing oocyte is adapted to be selective for the Y-bearing spermatozoa when maternal circulating androgens are relatively high. This study sought to determine whether maternal postpartum testosterone and estradiol can retrospectively predict the offspring sex at birth. The study was cross-sectional from December 2020 to April 2021 at the Reproductive and Child Health unit in Tamale. The participants were part of a previous study and comprised 178 mother-offspring dyads (mother-daughter = 90, mother-son = 88). The mothers were between the ages of 18 and 35 years and had a median (interquartile range-IQR) postpartum interval of 111 (60-187) days. A single venous blood sample was drawn from the mothers between 8.00 am and 12.00 pm local time on each day to reduce diurnal variation. Postpartum serum estradiol, testosterone, and sex hormone-binding globulin were assayed using the ELISA technique. The serum total testosterone and the testosterone-to-estradiol ratio (TT: E2 ) were higher in mothers with sons while estradiol was higher in mothers with daughters (p < 0.050). The total testosterone and TT: E2 did not markedly differ by their area under the curve (AUC: 0.91 and 0.99, respectively) but both were higher than the AUC of estradiol (0.72). The Sensitivity was 97.7%, 97.7%, and 94.5% and specificity, 88.9%, 40.0%, and 95.5% at cutoff points of >1.659 nmol/L, ≤141.862 pmol/L, and > 31.5, respectively for total testosterone, estradiol, and TT: E2 . The maternal testosterone-to-estradiol ratio may be more predictive of offspring sex at birth than either testosterone or estradiol alone.

Pathomorphological changes of the placenta in antenatal asphyxia of the fetus associated with the coronavirus disease (COVID-19) in pregnant women

The objective: to determine the pathomorphological changes in the placenta by antenatal asphyxia of the fetus associated with the coronavirus disease (COVID-19) in pregnant women.Materials and methods. 21 placentas by fetal antenatal asphyxia which occurred at different terms of pregnancy in women with COVID-19 were examined. COVID-19 was diagnosed by a positive PCR test – detection of SARS-CoV-2 RNA. The study groups were defined depending on the duration of the post-covid interval (time from the diagnosis of COVID-19 to delivery). I group (n=12) included placentas of women with antenatal fetal asphyxia, in whom the postpartum interval was 1–4 weeks; II group (n=9) – placentas of women with fetal death, in whom the postpartum interval was 5–14 weeks.In the I group, antenatal asphyxia of the fetus occurred in the term from the 13th to 36th weeks of gestation, in the II group – in period from the 29th to the 41st week. Macroscopic, organometric, microscopic methods of placenta research and a statistical method were applied. Fetal-placental index (FPI) was calculatedResults. In the studied cases, antenatal fetal death occurred in different terms of pregnancy, namely, from the 14th to the 41st week of gestation (median is 32 weeks). Pregnant women had COVID-19 from the 13th to the 35th week of gestation (median is 25 weeks); when the mother was diagnosed with COVID-19 after the 35th week, there was no case of antenatal fetal death. The severity of the course of the coronavirus disease was mild in 7 pregnant women, moderate – 12 persons, and a severe course with pneumonia was diagnosed in 2 women. The severity of morphological changes in the placenta did not depend on the severity of the course of COVID-19 in the pregnant woman (chorioamnionitis, p=1.0; intervillositis, p=0.63; obliteration of arterioles, p=0.32).In the I group, a slight increase in FPI was found up to 0.19 [0.12; 0.34], in the II group – a similar indicator was 0.16 [0.13; 0.24]. However, the absolute values of the weight of the fetus and placenta in both groups were lower than those for the given gestational age.The I group of placentas there were the pronounced inflammatory changes – placentitis: chorioamnionitis – 100% (95%CI: 85.4–100) and basal deciduitis – 91.7% (95%CI: 67.1–100). In the II group the inflammatory changes of the chorioamniotic membranes and basal plate were focal and were found in 6 placentas – 66.7% (95% CI: 29.2–94.8). Intervillositis was detected in 11 placentas – 91.7% (95%CI: 67.1–100) in the I group versus 2 placentas – 22.2% (95%CI: 1.1–58.9; p=0.006) in the II group.Villositis in the I group was determined in 8 cases – 66.7% (95%CI: 35.4–91.4) and in only one placenta in the II group – 11.1% (95%CI: 0.0–43.91; p=0.034). In the placentas of both groups the fibrinoid necrosis of the arteriole wall, proliferative changes in the vessel wall and necrosis of the endothelium were detected – 100% (95%CI: 85.4–100), dyscirculatory disorders (stasis, thrombosis, hemorrhages) were found in 75% (95% CI: 44.4–95.8) of cases in the I group and in 66.7% (95% CI: 29.2–94.8) – in the II group. An increased number of syncytial nodules was observed as a manifestation of compensatory mechanisms: in the I group – 83.3% (95%CI: 54.7–98.9), in the II group – 88.9% (95%CI: 56.1–100).All studied cases in the II group were accompanied by obliteration of the lumen of the arterioles of trunk and semi-trunk villi – 100% (95%CI: 80.9–100; p=0.0006), versus the I group – 16.7% (95%CI: 1.1–45.3). At the same time, in 6 cases in the II group the morphological manifestations of restoration of the lumen (revascularization) were detected – the formation of intravascular septa – 66.7% (95% CI: 29.2–94.8), which were not found in the I group (р=0.0093). In 100% (95%CI: 80.9–100) of placentas of the II group and in 66.7% (95%CI: 35.4–91.4) of the I group the stroma fibrosis of stem and semi-stem villi, obliteration intervillous space, and hypoplasia of terminal villi were determined.Conclusions. Statistically significant differences of placentas in antenatal asphyxia of the fetus depended on the length of the postcovid interval: in the postcovid interval of 1–4 weeks (I group) the inflammatory changes prevailed – placentitis: chorioamnionitis – 100% (95%CI: 85.4–100), intervillositis – 91.7% (95% CI: 67.1–100), p=0.006; villositis – 66.7% (95%CI: 35.4–91.4), p=0.034. When the duration of the postcovid interval increased to 5–14 weeks (II group), arteriosclerosis prevailed – 100% (95% CI: 80.9–100); p=0.0006.The cause of antenatal fetal death in the women with COVID-19 in the I group is acute placental insufficiency associated with the exudative phase of inflammation (chorioamnionitis, villositis, intervillositis). In the II group, the cause of antenatal fetal asphyxia is the formation of chronic placental dysfunction caused by the proliferation phase, which was manifested by proliferative changes in the muscular layer of arterioles and their subsequent fibrosis with obliteration of the lumen of arterioles (arteriosclerosis).

Effects of concentrate supplementation on reproductive traits of Co goats and growth performance of their kids under grazing condition

The experiment was conducted in A Luoi district, Thua Thien Hue province of Vietnam, to evaluate the effect of concentrate supplementation on the reproductive traits of local Co goats and growth performance of their kids. A total of 20 pregnant Co goats in the last 1.5 month of pregnancy were monitored in two reproductive cycles. Goats were randomly divided into two dietary treatments as control (CG), in which animals freely grazed, and experiment (EG), in which concentrates were supplemented at 1.0% and 1.5% BW in the late gestation and lactation periods, respectively. After kidding, kids in each treatment were kept with their mother to access milk for the whole study period. In the CG, the kids have no supplements, and in the EG, the kids of 1 to 3 months of age were supplemented the concentrate at 1.5% BW/day. The results indicated that higher body condition scores and body weights of does after kidding, 1 and 2 months postpartum were in the EG than in the CG. The supplementation of concentrate also reduced the postpartum and kidding intervals; and increased the number of litters per year of does. Furthermore, the supplementation of concentrate improved significantly the weaning weight of kids and financial benefit per doe/per litter. In conclusion, the supplementation of concentrate in late pregnancy period and lactation diets improved reproductive traits of local Co goats and also concentrate supplementation in kids’ diet improved growth performance under grazing condition.

Parental factors that impact the ecology of human mammary development, milk secretion, and milk composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 1

The goal of Working Group 1 in the Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project was to outline factors influencing biological processes governing human milk secretion and to evaluate our current knowledge of these processes. Many factors regulate mammary gland development in utero, during puberty, in pregnancy, through secretory activation, and at weaning. These factors include breast anatomy, breast vasculature, diet, and the lactating parent’s hormonal milieu including estrogen, progesterone, placental lactogen, cortisol, prolactin, and growth hormone. We examine the effects of time of day and postpartum interval on milk secretion, along with the role and mechanisms of lactating parent-infant interactions on milk secretion and bonding, with particular attention to the actions of oxytocin on the mammary gland and the pleasure systems in the brain. We then consider the potential effects of clinical conditions including infection, pre-eclampsia, preterm birth, cardiovascular health, inflammatory states, mastitis, and particularly, gestational diabetes and obesity. Although we know a great deal about the transporter systems by which zinc and calcium pass from the blood stream into milk, the interactions and cellular localization of transporters that carry substrates such as glucose, amino acids, copper, and the many other trace metals present in human milk across plasma and intracellular membranes require more research. We pose the question of how cultured mammary alveolar cells and animal models can help answer lingering questions about the mechanisms and regulation of human milk secretion. We raise questions about the role of the lactating parent and the infant microbiome and the immune system during breast development, secretion of immune molecules into milk, and protection of the breast from pathogens. Finally, we consider the effect of medications, recreational and illicit drugs, pesticides, and endocrine-disrupting chemicals on milk secretion and composition, emphasizing that this area needs much more research attention.

Abstract 6484: Impact of time between last childbirth and diagnosis of early-onset breast cancer on survival in germline BRCA1/2 carriers

Abstract INTRODUCTION: Young women diagnosed with breast cancer in close proximity to childbirth have increased risk of mortality compared to nulliparous women, and the postpartum period has been identified as a risk window for breast cancer metastasis. BRCA1/2 germline mutation carriers have a high risk of developing breast cancer at young age, yet it is unknown if recent childbirth is a poor prognostic risk factor for BRCA1/2 carriers. Here we assessed whether time between last childbirth and breast cancer diagnosis impacted survival among early-onset BRCA1/2 breast cancer patients. METHODS: The study population includes 903 female BRCA1/2 mutation carriers diagnosed with stage I-III breast cancer at ≤45 years of age between 1950 and 2021 in the UK. The primary outcome of this study is all-cause mortality. The primary exposures were no prior childbirth (n=224), or time between last childbirth and breast cancer diagnosis grouped as 0-&amp;lt;5 years (n=228), 5-&amp;lt;10 years (n=191), or ≥10 years since last childbirth (n=260). Cox proportional hazards regression was applied to identify factors associated with risk of 20-year mortality. RESULTS: Breast cancer diagnosed 5-&amp;lt;10 years after last childbirth was associated with an elevated risk for mortality [HR=1.56 (95% CI, 1.05-2.30)] compared to nulliparous cases after adjusting for patient age and tumor stage. Across groups, nulliparous women had the best prognosis, suggesting parity may increase risk of death in BRCA1/2 carriers. ER-negative cancers were the dominant tumor type across all groups: 54.8% (nulliparous), 52.6% [postpartum breast cancer (PPBC) &amp;lt;5], 58.4% (PPBC 5-&amp;lt;10), and 54.0% (≥10). ER-negative cases were more prevalent among BRCA1 carriers (77%) compared to BRCA2 carriers (24%). In stratified analyses by either ER or BRCA status, increased mortality in the PPBC 5-&amp;lt;10 group was significant for ER-negative cases [HR=3.12 (95% CI, 1.22-7.97)] and BRCA1 carriers [HR=2.03 (95% CI, 1.15-3.58)], compared to nulliparous groups. For ER-positive cases, 71% of cases were BRCA2 carriers, and the most significant postpartum interval among ER-positive cases was observed in the 0-&amp;lt;5 group [HR=2.35 (95% CI, 1.02-5.42)]. No association was observed for BRCA2 carriers with PPBC 0-&amp;lt;5 vs nulliparous groups [HR=1.26 (95% CI, 0.73-2.16)].CONCLUSION: Results suggest that BRCA1/2 breast cancer patients are at increased risk for all-cause mortality if diagnosed within 10 years of childbirth. For ER-positive disease, poorest prognosis occurs within 0-5 years postpartum, consistent with promotion of existing sub-clinical tumors. For BRCA2 carriers, the association between postpartum diagnosis and mortality is weak. For ER-negative disease, similar to BRCA1 carriers, poorest prognosis occurs 5-10 years postpartum, suggesting an interaction between BRCA1 and parity may result in increased tumor initiation. Citation Format: Zhenzhen Zhang, Shangyuan Ye, D Gareth Evans, Pepper Schedin. Impact of time between last childbirth and diagnosis of early-onset breast cancer on survival in germline BRCA1/2 carriers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6484.

Interrogating the Diversity of Vaginal, Endometrial, and Fecal Microbiomes in Healthy and Metritis Dairy Cattle

The bovine genital tract harbors a dynamic microbiome. Genital tract microbial communities in healthy animals have been characterized using next-generation sequencing methods showing that microbe compositions differ between the vagina and uterus, more so during the postpartum period. Pre-calving fecal and vaginal, and endometrial swabs at the different postpartum intervals were collected from dairy cows. Microbiomes in these samples were determined based on bacterial 16S amplicon sequencing and compared between healthy (H; n = 10) control animals and cows that developed metritis (M; n = 10) within 21 days postpartum (DPP). Compared to healthy animals the pre-calving fecal and vaginal microbiomes of metritis animals were more abundant in sequences from the phylum Fusobacteria and the bacterial genera such as Escherichia-Shigella and Histophilus. In addition, compared to healthy animals, metritis cows harboured low microbial species diversity in the endometrium, as well as decreasing Proteobacteria and increasing Fusobacteria, Firmicutes, Actinobacteria, and Bacteroidetes abundances. The greatest taxonomic compositional deviations in endometrial microbial communities between the metritis and health cows were detected between 7 and 10 DPP. There was high taxonomic similarity detected between postpartum endometrial microbiomes and the prepartum vaginal and fecal microbiomes suggesting that colonization through bacteria ascending from the rectum and vagina to the uterine cavity might play a major role in establishing the endometrial microbiome postpartum. A deeper understanding of the establishment and dynamics of postpartum endometrial microbial communities in cows will thus provide crucial basic knowledge to guide the development of genital microbiome manipulation strategies for preventing uterine disease and improving fertility in dairy cows.

Early vs Interval Postpartum Intrauterine Device Placement

The early postpartum period, 2 to 4 weeks after birth, may be a convenient time for intrauterine device (IUD) placement; the placement could then coincide with early postpartum or well-baby visits. To determine expulsion rates for IUDs placed early postpartum compared with those placed at the standard interval 6-week visit. In this randomized noninferiority trial, people who had a vaginal or cesarean birth were randomly assigned to undergo early (14-28 days) or interval (42-56 days) postpartum IUD placement. Clinicians blinded to participant study group used transvaginal ultrasonography to confirm IUD presence and position at the 6-month postpartum follow-up. The study assessed 642 postpartum people from 4 US medical centers, enrolled a consecutive sample of 404 participants from March 2018 to July 2021, and followed up each participant for 6 months postpartum. Early postpartum IUD placement, at 2 to 4 weeks postpartum, vs standard interval placement 6 to 8 weeks postpartum. The primary outcome was complete IUD expulsion by 6 months postpartum; the prespecified noninferiority margin was 6%. Secondary outcomes were partial IUD expulsion, IUD removal, pelvic infection, patient satisfaction, uterine perforation, pregnancy, and IUD use at 6 months postpartum. IUD malposition was an exploratory outcome. Among 404 enrolled participants, 203 participants were randomly assigned to undergo early IUD placement and 201 to undergo interval IUD placement (mean [SD] age, 29.9 [5.4] years; 46 [11.4%] were Black, 228 [56.4%] were White, and 175 [43.3%] were Hispanic). By 6 months postpartum, 53 participants (13%) never had an IUD placed and 57 (14%) were lost to follow-up. Among the 294 participants (73%) who received an IUD and completed 6-month follow-up, complete expulsion rates were 3 of 149 (2.0% [95% CI, 0.4%-5.8%]) in the early placement group and 0 of 145 (0% [95% CI, 0.0%-2.5%]) in the interval placement group (between-group difference, 2.0 [95% CI, -0.5 to 5.7] percentage points). Partial expulsion occurred in 14 (9.4% [95% CI, 5.2%-15.3%]) participants in the early placement group and 11 (7.6% [95% CI, 3.9%-13.2%]) participants in the interval placement group (between-group difference, 1.8 [95% CI, -4.8 to 8.6] percentage points). IUD use at 6 months was similar between the groups: 141 (69.5% [95% CI, 62.6%-75.7%]) participants in the early group vs 139 (67.2% [95% CI, 60.2%-73.6%]) in the interval group. Early IUD placement at 2 to 4 weeks postpartum compared with 6 to 8 weeks postpartum was noninferior for complete expulsion, but not partial expulsion. Understanding the risk of expulsion at these time points may help patients and clinicians make informed choices about the timing of IUD placement. ClinicalTrials.gov Identifier: NCT03462758.

Decision-making regarding immediate vs. interval postpartum levonorgestrel intrauterine device insertion timing

BackgroundUnderstanding decision-making for contraception initiation timing postpartum may help guide patients in selecting a contraceptive method most aligned with their reproductive goals. The objective of this study was to explore the decision-making process in patients who chose immediate postplacental (IPP) levonorgestrel intrauterine device (LNG IUD) insertion versus interval insertion at the postpartum follow-up visit.MethodsWe recruited English-speaking, reproductive-aged adult postpartum participants who received either an IPP or interval postpartum LNG IUD from September to December 2017 at MetroHealth Medical Center. We conducted interviews over the phone utilizing a pilot-tested, semi-structured interview guide. Interview topics included past experiences with contraception, provider counseling, intrapartum factors, and current experiences after IUD insertion.ResultsWe interviewed 20 participants (12 IPP and eight interval IUD recipients). Participants receiving an IPP IUD described convenience, desire for immediate contraception, pain control and availability of alternative contraception options as influential for their decision. Patients who received an interval IUD performed outside research, focused on the events surrounding delivery, and generally favored additional recovery time before obtaining an IUD. Patients who received interval IUDs were often not aware that IPP IUDs were available. Early, frequent, and comprehensive counseling was viewed favorably when compared to counseling upon arrival to the laboring unit. While overall there was congruence of participant expectations and experiences, unexpected expulsion affected desire for future IUD use in some participants.ConclusionProviders should be mindful that prior experience and knowledge as well as delivery room considerations affect insertion timing decision-making.Trial registrationN/A

Effects of Bacillus licheniformis and Combination of Probiotics and Enzymes as Supplements on Growth Performance and Serum Parameters in Early-Weaned Grazing Yak Calves

Early weaning is an effective strategy to improve cow feed utilization and shorten postpartum intervals in cows; however, this may lead to poor performance of the weaned calves. This study was conducted to test the effects of supplementing milk replacer with Bacillus licheniformis and a complex of probiotics and enzyme preparations on body weight (BW), size, and serum biochemical parameters and hormones in early-weaned grazing yak calves. Thirty two-month-old male grazing yaks (38.89 ± 1.45 kg body weight) were fed milk replacer at 3% of their BW and were randomly assigned to three treatments (n = 10, each): T1 (supplementation with 0.15 g/kg Bacillus licheniformis), T2 (supplementation with a 2.4 g/kg combination of probiotics and enzymes), and a control (without supplementation). Compared to the controls, the average daily gain (ADG) from 0 to 60 d was significantly higher in calves administered the T1 and T2 treatments, and that from 30 to 60 d was significantly higher in calves administered the T2 treatment. The ADG from 0 to 60 d was significantly higher in the T2- than in the T1-treated yaks. The concentration of serum growth hormone, insulin growth factor-1, and epidermal growth factor was significantly higher in the T2-treated calves than in the controls. The concentration of serum cortisol was significantly lower in the T1 treatment than in the controls. We concluded that supplementation with probiotics alone or a combination of probiotics and enzymes can improve the ADG of early-weaned grazing yak calves. Supplementation with the combination of probiotics and enzymes had a stronger positive effect on growth and serum hormone levels, compared to the single-probiotic treatment with Bacillus licheniformis, providing a basis for the application of a combination of probiotics and enzymes.

Concentrations and predictors of aluminum, antimony, and lithium in breast milk: A repeated-measures study of donors

Aluminum (Al), antimony (Sb), and lithium (Li) are relatively common toxic metal(oid)s that can be transferred into breast milk and potentially to the nursing infant. This study assessed concentrations of Al, Sb, and Li in breast milk samples collected from donor mothers and explored the predictors of these concentrations. Two hundred forty-two pooled breast milk samples were collected at different times post-partum from 83 donors in Spain (2015–2018) and analyzed for Al, Sb, and Li concentrations. Mixed-effect linear regression was used to investigate the association of breast milk concentrations of these elements with the sociodemographic profile of the women, their dietary habits and utilization of personal care products (PCPs), the post-partum interval, and the nutritional characteristics of milk samples, among other factors. Al was detected in 94% of samples, with a median concentration of 57.63 μg/L. Sb and Li were detected in 72% and 79% of samples at median concentrations of 0.08 μg/L and 0.58 μg/L, respectively. Concentrations of Al, Sb, and Li were not associated with post-partum time. Al was positively associated with total lipid content of samples, weight change since before pregnancy, and coffee and butter intakes and inversely with meat intake. Li was positively associated with intake of chocolate and use of face cream and eyeliner and inversely with year of sample collection, egg, bread, and pasta intakes, and use of hand cream. Sb was positively associated with fatty fish, yoghurt, rice, and deep-fried food intakes and use of eyeliner and inversely with egg and cereal intakes and use of eyeshadow. This study shows that Al, Sb, and Li, especially Al, are widely present in donor breast milk samples. Their concentrations in the milk samples were most frequently associated with dietary habits but also with the lipid content of samples and the use of certain PCPs.

La inflamación uterina de la vaca postparto. Del dicho al hecho…

Reproductive efficiency is one of the most important factors determining the genetic progress and productivity of cattle herds. To maintain acceptable reproductive efficiency, it is necessary for cows to have a calving interval of less than 400 days; a calving-conception interval of less than 110 days and less than 3 services per conception. Reproductive efficiency largely depends on the health and fertility of the herd. Postpartum uterine inflammation (metritis/endometritis/pyometra) is one of the main causes of poor reproductive performance in dairy and dual purpose herds. This condition results in low pregnancy rates, high number of services per conception, long postpartum intervals, high culling rates, and substantial economic losses (Gilbert et al., 2016). There is a great discrepancy in the criteria for diagnosis and treatment of puerperal metritis in dairy farms. In the case of endometritis, the situation is even more critical, because diagnosis is not routinely carried out at the field level, which limits the timely establishment of treatments and preventive management measures.