Período pós-parto e infecção pelo novo coronavírus: revisão de escopo / Postpartum period and infection by the new coronavirus: a scoping review / Periodo posparto e infección por el nuevo coronavirus: revisión del alcance

Objetivo: mapear as evidências disponíveis na literatura acerca dos manejos e desfechos da infecção pelo novo coronavírus no puerpério. Método: revisão de escopo conforme o Institute Joanna Briggs, desenvolvida em quatro fontes de dados eletrônicas. A extração, análise e síntese dos dados foi realizada por quatro pesquisadores independentes. Resultados: Nove publicações foram revisadas de 188 localizadas. Seis foram os países produtores das evidências, todas obtidas e publicadas em 2020. Vinte e um casos de COVID-19 no puerpério estiveram tratados nestas publicações, sendo 15 (71,4%) relativos a evoluções graves/exacerbação da doença e seis (28,6%) diagnosticados após a alta hospitalar. Conclusão: O mapeamento aponta para a ocorrência da infecção ou seu agravamento no período pós-parto, com indicativas ao monitoramento de sinais e sintomas, exploração diagnóstica e tratamento acurado e necessidade de acompanhamento próximo das mulheres diagnosticadas com COVID-19, sintomáticas ou não, no período pós-parto.

Objective: to map the evidence available in the literature about management and outcomes of postpartum infection by the new coronavirus. Method: scoping review conducted in four electronic sources, following Joanna Briggs Institute guidelines. Data were extracted, analyzed and summarized by four researchers independently. Results: nine of the 188 publications located were reviewed. The evidence, all obtained and published in 2020, was produced in six countries. These publications considered 21 cases of postpartum COVID-19, 15 (71.4%) of which related to severe developments / exacerbation of the disease and six (28.6%) diagnosed after hospital discharge. Conclusion: the mapping points to the occurrence of infection or worsening of the disease in the postpartum period, indicating the need for monitoring of signs and symptoms, diagnostic exploration and accurate treatment and the need for close monitoring of postpartum women diagnosed with COVID-19, whether symptomatic or not.

Objetivo: mapear las evidencias disponibles en la literatura sobre el manejo y los resultados de la infección por el nuevo coronavirus en el período posparto. Método: revisión del alcance según el Instituto Joanna Briggs, desarrollada en cuatro fuentes de datos electrónicas. La extracción, el análisis y la síntesis de los datos fueron realizados por cuatro investigadores independientes. Resultados: se revisaron nueve publicaciones de 188 encontradas. Fueron seis los países que produjeron las evidencias, obtenidas y publicadas en 2020. En estas publicaciones se trataron 21 casos de COVID-19 en el período posparto, 15 (71,4%) de los cuales estaban relacionados con evoluciones graves/exacerbación de la enfermedad y seis (28,6%) diagnosticados tras el alta hospitalaria. Conclusión: el mapeo apunta hacia la ocurrencia de la infección o su agravamiento en el posparto, con indicaciones de seguimiento de indicios y síntomas, exploración diagnóstica, tratamiento preciso y la necesidad de un seguimiento cercano a las mujeres diagnosticadas con COVID-19, sintomáticas o no, en el período posparto.

Plasma metabolite changes in anestrous dairy cows with negative energy balance identified using 1H NMR technology / [Alterações do metabólito plasmático em vacas leiteiras com balanço energético negativo identificado usando a tecnologia 1H NMR]

The objective of the present study was to investigate the different plasma metabolites between anestrus and estrus postpartum dairy cows and to provide a theoretical basis for prevention of anestrus in dairy farm cows. In the experiment, one hundred and sixty-seven Holstein dairy cows were selected with similar age and parity. According to the concentration of ß-hydroxybutyric acid, non-esterified fatty acids and glucose in plasma during 14 to 21 days in milk, all dairy cows were determined as having a status of energy balance. According to the results of clinical symptom, rectal and B ultrasound examination at 60 to 90 days postpartum, these cows were divided into twenty estrus and twenty-four anestrus group, other dairy cows were removed. 1H nuclear magnetic resonance technology was utilized to detect the plasma metabolites changes and screen different plasma metabolites between anestrus and estrus cows. Ten different metabolites including alanine, glutamic acid, asparagine, creatine, choline, phosphocholine, glycerophosphocholine, low-density lipoprotein, and very-low-density lipoprotein were significantly decreased in anestrous cows compared with estrous cows. Metabolic pathway analyses indicated that differential metabolites were primarily involved in amino acid and glycerophospholipid metabolism. These metabolites and their enrichment pathways indicate that reduced steroid hormone synthesis precursors result in lower levels of estradiol and progesterone and cause anestrus in negative energy balance. These data provide a better understanding of the changes that may affect estrus of postpartum dairy cows at NEB status and lay the ground for further research.(AU)

O objetivo do presente estudo foi investigar os diferentes metabolitos do plasma entre o cio e o cio pós-parto de vacas leiteiras e fornecer uma base teórica para a prevenção do cio de vacas em fazendas de leite. No experimento, foram selecionadas 127 vacas leiteiras Holstein com idade e paridade similares. De acordo com a concentração de ß- ácido hidroxibutírico, ácidos graxos não esterificados e glicose no plasma entre 14 e 21 dias no leite, todas as vacas leiteiras foram determinadas em estado de equilíbrio energético. De acordo com os resultados dos sintomas clínicos, do exame de ultra-som retal e B aos 60 a 90 dias pós-parto, estas vacas foram divididas em vinte cios e vinte e quatro grupos de cio, outras vacas leiteiras foram removidas. A tecnologia de ressonância magnética nuclear 1H foi utilizada para detectar as alterações dos metabólitos plasmáticos e para triar diferentes metabólitos plasmáticos entre as vacas do cio e do cio. Dez diferentes metabólitos incluindo alanina, ácido glutâmico, asparagina, creatina, colina, fosfocholina, glicerofosfocolina, lipoproteína de baixa densidade e lipoproteína de muito baixa densidade foram significativamente diminuídos nas vacas antróficas em comparação com as vacas estro. As análises da via metabólica indicaram que os metabólitos diferenciais estavam principalmente envolvidos no metabolismo de aminoácidos e glicerofosfolipídios. Estes metabólitos e suas vias de enriquecimento indicam que a redução dos precursores da síntese de hormônios esteróides resulta em níveis mais baixos de estradiol e progesterona e causa anestros no balanço energético negativo. Estes dados fornecem uma melhor compreensão das mudanças que podem afetar o cio das vacas leiteiras pós-parto no estado de NEB e preparam o terreno para mais pesquisas.(AU)

Avaliação da atividade funcional dos neutrófilos sanguíneos em ovelhas primíparas e pluríparas da raça Lacaune / [Functional evaluation of blood neutrophils in primiparous and pluriparous Lacaune ewes]

This study aimed to evaluate the neutrophil oxidative metabolism and phagocytosis of Zymonsan particles of primiparous and pluriparous Lacaune ewes during the first 30 days after lambing. A total of 20 ewes were evaluated, 10 primiparous (GPR) and 10 pluriparous (GPL). Evaluation of basal oxidative metabolism was performed using the nitroblue tetrazolium (NBT) technique, stimulating neutrophil phagocytosis with Zymosan particles. Blood samples were collected at parturition day (M1) and 1, 3, 7, 15 and 30 days after parturition, corresponding to M2, M3, M4, M5 and M6, respectively. In relation to the groups, GPR presented lower oxidative basal metabolism neutrophils in M1 compared to M4, in M3 with M1, M2, M4 and M5. In M4 and M5 differences were found at all times and in M6 with M4 and M5. Higher percentage of neutrophils than phagocytes were found in M4, M5 and M6 than in M1 and M2 in GPL animals. At all times GPR presented a lower percentage of phagocytosis than GPL. Thus it is concluded that the immune response in pluriparous sheep was more efficient than in primiparous sheep.(AU)

Avaliação da prevalência de anemia pós-parto e fatores associados em uma maternidade terciária do estado do Piauí / Prevalence of postpartum anemia and associated factors in a tertiary maternity hospital of the state of Piaui

Este trabalho avaliou a prevalência de anemia puerperal por meio das dosagens de hemoglobina (Hb) e hematócrito (Ht) numa maternidade pública terciária do estado do Piauí e os fatores de risco associados à presença de anemia. No total, 198 puérperas internadas na maternidade foram submetidas a entrevista e análise do prontuário e do cartão pré-natal. Foram feitas coletas de amostra de sangue venoso periférico antes do parto, 24 horas após o parto vaginal e 48 horas após o parto cesariano. A prevalência de anemia pós-parto encontrada na maternidade estudada foi de 27,27%. A presença de anemia pré-parto e gemelaridade e o ganho de peso foram os fatores de risco significativamente associados à anemia pós-parto.(AU)

This study evaluated the prevalence of puerperal anemia using hemoglobin (Hb) and hematocrit (Ht) measurements in a public tertiary maternity hospital in the state of Piauí and the risk factors associated with the presence of anemia. In total, 198 puerperal women admitted to the maternity hospital were interviewed, analyzed the medical record and the prenatal card. A peripheral venous blood sample was collected before delivery, 24 hours after vaginal delivery and 48 hours after cesarean delivery. The prevalence of postpartum anemia found in the maternity studied was 27.27%. The presence of pre-delivery anemia, twinning and weight gain were the risk factors significantly associated with postpartum anemia.(AU)

Influência de variáveis sociodemográficas, clínicas, obstétricas e neonatais na qualidade de vida de puérperas / Influence of sociodemographic, clinical, obstetric and neonatal variables on postpartum quality of life / Influencia de variables sociodemográficas, clínicas, obstétricas y neonatales en la calidad de vida posparto

Objetivo: analisar a qualidade de vida (QV) das puérperas e correlacioná-la com variáveis sociodemográficas, clínicas, obstétricas e neonatais. Método: estudo quantitativo, de delineamento transversal realizado em um hospital de ensino de Uberaba-MG. Foram entrevistadas 103 puérperas. Os dados foram coletados em 2017 e analisados por estatística descritiva simples, correlação de Pearson e o Teste t de Student. Para mensurar os escores de QV foi utilizado o instrumento Índice de Qualidade de Vida de Ferrans e Powers. O projeto foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: puérperas adolescentes, renda superior a dois salários, número de consultas pré-natal, recém-nascido (RN) macrossômico e Apgar no primeiro minuto favoreceram a melhor QV. Intercorrências durante gestação e/ou durante o parto, problemas de saúde do RN e etilismo prejudicaram a QV. Conclusão: as puérperas apresentaram altos escores de QV, destacando-se os domínios família e psicoespiritual. Aspectos sociodemográficos, clínicos, obstétricos e neonatais influenciaram a QV.

Objective: to analyze the quality of life (QOL) of postpartum women and to correlate it with sociodemographic, clinical, obstetric and neonatal variables. Method: quantitative, cross-sectional study conducted in a teaching hospital in Uberaba-MG. 103 postpartum women were interviewed. Data were collected in 2017 and analyzed using simple descriptive statistics, Pearson correlation and Student's t-test. To measure QoL scores, the Ferrans and Powers Quality of Life Index instrument was used. The project was approved by the Research Ethics Committee. Results: adolescent mothers, income higher than two minimum wages, number of prenatal consultations, newborns over 4,000g and high Apgar score in the first minute favored the best QOL. Complications during pregnancy and / or childbirth, newborn health problems and alcoholism impaired QOL. Conclusion: the puerperal women had high QoL scores, highlighting the family and psycho-spiritual domains. Sociodemographic, clinical, obstetric and neonatal aspects influenced QOL.

Objetivo: analizar la calidad de vida (CV) de las madres y correlacionarla con variables sociodemográficas, clínicas, obstétricas y neonatales. Método: estudio transversal cuantitativo realizado en un hospital universitario de Uberaba-MG. Se entrevistaron 103 mujeres posparto. Los datos se recopilaron en 2017 y se analizaron mediante estadísticas descriptivas simples, correlación de Pearson y prueba t de Student. Para medir los puntajes de la calidad de vida, se utilizó el instrumento Ferrans and Powers Quality of Life Index. El proyecto fue aprobado por el Comité de Ética en Investigación. Resultados: madres adolescentes, ingresos superiores a dos salarios mínimos, número de consultas prenatales, recién nacidos de más de 4.000 gy puntaje de Apgar alto en el primer minuto favorecieron la mejor calidad de vida. Complicaciones durante el embarazo y / o parto, problemas de salud del recién nacido y la calidad de vida deteriorada por el alcoholismo. Conclusión: las mujeres puerperales tuvieron altos puntajes de calidad de vida, destacando los dominios familiar y psicoespiritual. Los aspectos sociodemográficos, clínicos, obstétricos y neonatales influyeron en la calidad de vida.

TBARS and BDNF levels in newborns exposed to crack/cocaine during pregnancy: a comparative study

Objectives: To compare levels of a marker of lipid peroxidation (thiobarbituric acid reactive substances, TBARS) and brain-derived neurotrophic factor (BDNF) in umbilical cord blood (UCB) between newborns exposed to crack/cocaine in utero (exposed newborns [EN], n=57) and non-exposed newborns (NEN, n=99), as well as in maternal peripheral blood at delivery. Methods: This was a cross-sectional study. Potential confounders, including perinatal parameters, psychopathology, and use of other substances, were assessed. Results: After adjusting for potential confounders, adjusted mean BDNF was significantly higher in EN (3.86 ng/mL, 95% confidence interval [95%CI] 2.29-5.43) than in NEN (0.85 ng/mL, 95%CI 0.47-1.23; p < 0.001; Cohen effect size: 1.12), and significantly lower in crack/cocaine mothers than in control mothers (4.03 ng/mL, 95%CI 2.87-5.18 vs. 6.67 ng/mL, 95%CI 5.60-7.74; p = 0.006). The adjusted mean TBARS level was significantly lower in EN (63.97 µM MDA, 95%CI 39.43-88.50) than NEN (177.04 µM MDA, 95%CI 140.93-213.14; p < 0.001; effect size = 0.84), with no difference between mother groups (p = 0.86). Conclusions: The changes in TBARS levels observed in EN suggest that fetuses exposed to cocaine mobilize endogenous antioxidant routes since very early stages of development. The increase in BDNF levels in EN might indicate changes in fetal development, whereas the changes in BDNF levels in mothers provide evidence of the complex metabolic processes involved in drug use during pregnancy.

Profile of plasmatic progesterone on pregnancy, and the postpartum estrus of Dasyprocta prymnolopha (Rodentia: Dasyproctidae) / Perfil de la progesterona plasmática durante durante la preñez y celo posparto del Dasyprocta prymnolopha (Rodentia: Dasyproctidae)

Abstract:The agouti (Dasyprocta sp.) is a hystricomorph rodent found in some regions of the Americas. It is an important cynegetic species, which indicates that the overhunting is a threat to their conservation. Very little is known about this wildlife in relation to what already has been studied in domestic animals. Thus, the knowledge on reproduction of wildlife becomes necessary and essential for the management and conservation of these natural resources. Specifically, studies regarding hormonal monitoring are important as a basic tool for research in modern reproductive biotechnology, and currently, there is no information on the progesterone changes during pregnancy of Dasyprocta sp., compared to other hystricomorphs. The aim of this study was to describe the profile of plasmatic progesterone during pregnancy, and report the restart of ovarian cycle in agouti after parturition. For this purpose, 18 black-rumped agoutis (Dasyprocta prymnolopha) born in captivity were used, and one or more consecutive pregnancies were observed. Copulation was confirmed by the presence of spermatozoa observed in the colpocytological examination. Blood samples were collected two times per week, and concentrations of progesterone, assessed in ten agoutis, were determined by radioimmunoassay. The onset of ovarian activity in six females was observed daily by colpocytological examination, starting on the seventh day postpartum. The gestational period observed in this study was 104.04 days (SD = 1.31) (101-106 days) (Number of cases, N = 26), and the interval between births was 126.03 days (SD = 18.40) (109-184 days). The plasmatic profile of progesterone during pregnancy showed a progressive increase from the 1st to the 5th week. The higher progesterone levels over this period (6.88 ng / mL, SD = 3.01) were detected in the 5th week. This value was similar (One-Way ANOVA, p > 0.05) to that observed in the 4th and 6th weeks, but was statistically different (One-Way ANOVA, p < 0.05) when compared to the other weeks. After the 6th week there was a progressive decrease in plasmatic progesterone levels. The animals showed a postpartum estrus of 12.04 days (SD= 4.29) (7-24 days) (N= 23). It was observed that 80.95 % (N= 19) of copulations during this period were fertile. This work contributed to understanding the dynamic changes in the progesterone levels during the pregnancy in agouti. Nevertheless, more studies are needed for a better appreciation of other endocrine and biological changes, in the mother and feto-placental unit of the agouti. Rev. Biol. Trop. 64 (4): 1519-1526. Epub 2016 December 01.

Resumen:El agouti (Dasyprocta sp.) es un roedor histricomorfo encontrado en algunas regiones de América. Es una especie cinegética importante, lo que indica que la caza excesiva es una amenaza para su conservación. Muy poco es lo que se conoce acerca de la biología de los animales silvestres, en relación al conocimiento acumulado sobre los domésticos. Por lo tanto, el estudio sobre la reproducción de los animales silvestres se hace necesario e imprescindible para el manejo y conservación de la especie como recurso natural. En concreto, los estudios relativos a la monitorización hormonal son una herramienta básica para la investigación en biotecnología reproductiva moderna. No hay información sobre los cambios de progesterona durante la preñez de Dasyprocta sp. en comparación con otros histricomorfos. El objetivo de este estudio fue describir el perfil de la progesterona plasmática durante la preñez, y reportar el reinicio del ciclo ovárico después del parto. Para ello, se utilizaron 18 agoutis de rabo negro (Dasyprocta prymnolopha) nacidos en cautiverio. Fueron estudiadas una o más preñeces consecutivas. La copulación fue confirmada por la presencia de espermatozoides observados en examen colpocitológico. Las muestras de sangre se recogieron dos veces por semana, y las concentraciones de progesterona se determinaron en 10 individuos mediante radioinmunoensayo. Se observó el inicio de la actividad ovárica diaria por examen colpocitológico, comenzando en el día séptimo posparto. El período gestacional observado en este estudio fue de 104.04 días (SD= 1.31, rango entre 101-106 días, N= 26), y el intervalo entre los nacimientos fue 126.03 días (SD= 18.40, rango entre 109-184 días). El perfil plasmático de la progesterona durante el embarazo mostró un aumento progresivo de la 1ª a la 5ª semana. Los mayores niveles de progesterona durante este período (6.88 ng / mL, SD= 3.01) se detectaron en la quinta semana. Este valor fue similar (ANOVA de um factor, p > 0.05) al observado en las semanas cuatro y seis, pero fue estadísticamente diferente (ANOVA de um factor, p<0.05) en comparación con las otras semanas. Después de la sexta semana hubo una disminución progresiva en los niveles plasmáticos de progesterona. Los animales mostraron un estro posparto de 12.04 días (SD= 4.29, rango entre 7-24 días, N= 23). Se observó que el 80.95 % (N= 19) de cópulas durante este período fueron fértiles. Este trabajo contribuyó a la comprensión de los cambios dinámicos en los niveles de progesterona durante la preñez del agouti. Sin embargo, se necesitan más estudios para una mejor comprensión de otros cambios biológicos y endocrinos, y en la unidad materna y feto-placentaria del agouti.

Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study

Objective: Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1) to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2) to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3) to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Methods: Thirty-three healthy pregnant women were recruited from the Women’s Health Concerns Clinic at St. Joseph’s Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL)-6, IL-10, tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Results: Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001), IL-6 (p = 0.025), and IL-10 (p = 0.006) were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS) score. Conclusions: Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.

Postpartum Reclassification of Glycemic Status in Women with Gestational Diabetes Mellitus and Associated Risk Factors / Reclassificação pós-parto do estado glicêmico em mulheres com diabetes mellitus gestacional e fatores de risco associados

Abstract Objective The aims of the study were to evaluate, after pregnancy, the glycemic status of women with history of gestational diabetes mellitus (GDM) and to identify clinical variables associated with the development of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). Methods Retrospective cohort of 279 women with GDM who were reevaluated with an oral glucose tolerance test (OGTT) after pregnancy. Characteristics of the index pregnancy were analyzed as risk factors for the future development of prediabetes (IFG or IGT), and T2DM. Results: T2DM was diagnosed in 34 (12.2%) patients, IFG in 58 (20.8%), and IGT in 35 (12.5%). Women with postpartum T2DM showed more frequently a family history of T2DM, higher pre-pregnancy body mass index (BMI), lower gestational age, higher fasting and 2-hour plasma glucose levels on the OGTT at the diagnosis of GDM, higher levels of hemoglobin A1c, and a more frequent insulin requirement during pregnancy. Paternal history of T2DM (odds ratio [OR] =5.67; 95% confidence interval [95%CI] =1.64-19.59; p =0.006), first trimester fasting glucose value (OR =1.07; 95%CI =1.03-1.11; p =0.001), and insulin treatment during pregnancy (OR =15.92; 95%CI =5.54-45.71; p < 0.001) were significant independent risk factors for the development of T2DM. Conclusion A high rate of abnormal glucose tolerance was found in women with previous GDM. Family history of T2DM, higher pre-pregnancy BMI, early onset of GDM, higher glucose levels, and insulin requirement during pregnancy were important risk factors for the early identification of women at high risk of developing T2DM. These findings may be useful for developing preventive strategies.

Objetivo Os objetivos do estudo foram avaliar o estado glicêmico de mulheres com história de diabetes mellitus gestacional (DMG) após o parto e identificar fatores associados ao desenvolvimento de diabetes mellitus tipo 2 (DM2), glicemia de jejum alterada (GJA) e tolerância diminuída à glicose (TDG). Métodos Coorte retrospectiva de 279 mulheres com DMG reavaliadas com um teste oral de tolerância à glicose (TOTG) após a gestação. Foram analisados fatores prognósticos da gestação índice e fatores de risco para o futuro desenvolvimento de pré-diabetes (GJA ou TDG) e DM2. Resultados: Diagnosticou-se DM2 em 34 pacientes (12,2%), GJA em 58 (20,8%) e TDG em 35 (12,5%). Mulheres que evoluíram para DM2 apresentaram maior frequência de história familiar de DM2, índice de massa corporal (IMC) pré-gestacional mais elevado, menor idade gestacional, níveis superiores de glicemia de jejum e 2 horas após glicose no TOTG ao diagnóstico do DMG, hemoglobina glicada mais elevada, e uso mais frequente de insulina na gestação. História paterna de DM2 (odds ratio [OR] = 5,67; intervalo de confiança de 95% [IC95%] = 1,64-19,59; p = 0,006), glicemia de jejum do primeiro trimestre (OR = 1,07; IC95% = 1,03-1,11; p = 0,001) e o uso de insulina na gestação (OR = 15,92; IC95% = 5,54-45,71; p < 0,001) foram fatores de risco independentes para o desenvolvimento de DM2. Conclusão Houve elevada incidência de alterações no metabolismo da glicose em mulheres com DMG prévio. História familiar de DM2, IMC pré-gestacional elevado, DMG diagnosticado mais precocemente na gestação, com glicemias mais elevadas e necessidade de insulina, foram importantes fatores de risco associados à identificação precoce de mulheres com alto risco de desenvolvimento de DM2. Este conhecimento pode ser útil para o desenvolvimento de estratégias de prevenção.

Alterações nos parâmetros hematológico durante a gestação e no pós-parto de cabras da raça Saanen criadas no sul do Espírito Santo / Changes in hematological parameters during the gestation period and postpartum in Saanen goats raised in southern Espirito Santo, Brazil

O objetivo deste estudo foi avaliar o perfil hematológico de cabras da raça Saanen em diferentes fases da gestação e no pós-parto. Para sua realização foram utilizadas 24 cabras gestantes e 10 não gestantes da raça Saanen, criadas em condições intensivas no município de Alegre, Espírito Santo. As amostras foram coletadas dos 60 aos 135 dias de gestação, com intervalos de 15 dias entre as coletas. Após a parição foram realizadas mais duas coletas, também com intervalos de 15 dias. As amostras de sangue coletadas foram refrigeradas até a chegada ao laboratório, onde foi realizado o eritrograma e a leucometria global em analisador automático e as contagens diferenciais em esfregaço sanguíneo. Após análise dos resultados pode-se observar que, nas cabras avaliadas, houve influência do período de gestação, do pós-parto e da ordem de parto sobre os valores do eritrograma. Todos parâmetros avaliados, exceto VGM, diminuiram com o avançar da gestação até os quinze dias pós-parto, sendo que as maiores alterações ocorreram no final da gestação. A leucometria global (LG) e específica também apresentaram diferenças significativas de acordo com o estado fisiológicos das fêmeas. Os valores médios de LG foram de 10.579 a 15.836 leucócitos/mm3. Fêmeas não gestantes apresentaram maiores valores de LG, diminuindo com a gestação até os 15 dias do pós-parto. Trinta dias pós-parto o valor de LG aumentou, assemelhando-se aos valores das cabras não gestantes. Os valores absolutos de neutrófilos segmentados seguiram a mesma tendência da LG. A quantidade de linfócitos apresentou diminuição a partir dos 120 dias de gestação, aumentando a partir dos trinta dias pós-parto. A quantidade de eosinófilos não sofreu alteração de acordo com o estado fisiológico e a quantidade de basófilos foi maior em fêmeas não gestantes. Para monócitos os resultados foram em geral superiores nas cabras não gestantes e com 120 a 135 dias de gestação. Com relação a ordem de parição observou-se que fêmeas com mais de quatro partos apresentaram menores valores de VG, não havendo diferenças nos outros parâmetros do eritrograma. A LG foi maior na cabras com quatro partos, principalmente devido ao aumento de neutrófilos, enquanto que a quantidade de linfócitos foi menor nestas cabras. Os resultados encontrados evidenciaram a influência da gestação, do pós-parto e da ordem de parto das fêmeas da raça Saanen estudadas sobre os parâmetros hematológicos e também a necessidade da realização de estudos para se determinar os valores de referência do hemograma dos caprinos para cada tipo de criação, estado fisiológico e raça.(AU)

The aim of this study was to evaluate the hematological profile of Saanen goats at different stage of pregnancy and postpartum. For this study were uses 24 pregnant goats and 10 non-pregnant Saanen raised in intensive conditions in the Alegre city, Espirito Santo state. Samples were collected from 60 to 135 days of gestation, with intervals of 15 days between collections. After parturition were performed two more collections, also with intervals of 15 days. The blood samples were refrigerated until arrival at the laboratory. It was possible to perform the red blood cell (RBC) count, packed cell volume (PCV), hemoglobin, mean cell volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and the white blood cell (WBC) count, on an automatic analyzer and the blood smears were stained whit panoptic stain for differential WBC counts. After analyzing results it can be seen that in goats assessed no influence of gestation, delivery and postpartum on the order of the values of the erythrocyte. All evaluated parameters except MCV, decreased with advancing gestation until fifteen days after birth, with the largest changes occurred in late pregnancy. The WBC and differential also showed significant differences according to the physiological stage of the females. The average values of WBC were 10579 e 15836 leukocytes/mm3. Non pregnant females showed higher WBC, with decreasing gestation until 15 days of postpartum. Thirty days postpartum increased the value of WBC, resembling the values of non-pregnant goats. The absolute values of segmented neutrophils followed the same trend of WBC. the number of lymphocytes showed decrease a 120 days of pregnancy, increasing from thirty days postpartum. The number of eosinophil was not changed according to the physiological state and the number of basophils was higher in non-pregnant females. For monocytes results were generally higher in non-pregnant goats and 120-135 days of gestation. With respect to parity other was observed that females with more than four birth a lower values of PVC, there were no differences in the other parameters of the erythrocyte. WBC was higher in goats with four deliveries, mainly due the increase of neutrophils, whereas the number of lymphocytes was lower in these goats. Already the number of lymphocytes was lower in goats with four birth. The results showed the influence of pregnancy, postpartum and the order of birth of the Saanen females studied on the hematological parameters and the need for studies to determine references values of blood cell counts for each type of goats breed.(AU)

Functional activity of neutrophilic polymorphonuclear leukocytes in the first five days postpartum / Atividade funcional de leucócitos polimorfonucleares neutrofílicos nos primeiros cinco dias após o parto

PURPOSE: To assess the chemotactic activity and phagocytic response of neutrophilic polymorphonuclear leukocytes among women in the first five days postpartum.METHODS: A prospective, cross-sectional clinical-laboratory study was conducted. Data of 31 postpartum women during the first five days after vaginal delivery were compared with those of 24 healthy non-pregnant non-postpartum women matched for age. The inclusion criteria were postpartum, clinically and obstetrically healthy women; vaginal delivery, singleton pregnancy carried to term; non-hypertensive, hyperglycemic, allergic, malnourished or with autoimmune or neoplastic diseases; not having received vaccines or blood products in the last three months. The Control Group was chosen according to the same inclusion criteria but involving non-pregnant non-postpartum women. The chemotactic activity of neutrophilic polymorphonuclear leukocytes was assessed by determining the distance from directed migration to bacterial lipopolysaccharide, in three Boyden chamber assays. The phagocytic response was identified by assessing the Zymosan particles' ingestion in three assays carried out in Leighton tubes. The Student's t-test was used in the statistical analysis, adopting a 5% level of significance.RESULTS: The chemotactic activity of neutrophilic polymorphonuclear leukocytes from postpartum women in the presence of homologous (73.2±6.9) and autologous (78.6±13.9) sera showed a significant increase compared to the values observed in the Control Group (64.1±4.1 and 66.6±5.4). Both chemotactic response and phagocytosis ingestion phase of neutrophilic polymorphonuclear leukocytes were significantly increased (p<0.05) in postpartum women compared to healthy non-pregnant and non-postpartum women.CONCLUSION: There was an increase in the chemotactic activity and phagocytic response of neutrophilic polymorphonuclear leukocytes during the first five days after vaginal delivery in women.

OBJETIVO: Avaliar a atividade quimiotática e a resposta fagocitária dos leucócitos polimorfonucleares neutrofílicos entre puérperas nos cinco primeiros dias após o parto.MÉTODOS: Um estudo clínico-laboratorial prospectivo e transversal foi realizado. Dados de 31 puérperas nos cinco primeiros dias após o parto vaginal foram comparados aos de 24 mulheres saudáveis não gestantes e não puérperas, por meio da idade. Os critérios de inclusão foram puérperas clínica e obstetricamente saudáveis; parto vaginal; gestação de feto único a termo; não hipertensas, hiperglicêmicas, alérgicas ou desnutridas ou portadoras de doenças autoimunes ou neoplasias; sem terem recebido vacinas ou hemoderivados nos últimos três meses. O Grupo Controle foi selecionado utilizando-se os mesmos critérios, mas com mulheres não gestantes e não puérperas. A atividade quimiotática por leucócitos polimorfonucleares neutrofílicos foi avaliada determinando-se a distância da migração dirigida ao lipopolissacarídeo bacteriano em três ensaios utilizando-se câmaras de Boyden. A resposta fagocitária foi identificada por meio da ingestão de partículas de zymosan em três ensaios, que foram realizados em tubos de Leighton. Na análise estatística, empregou-se o teste tde Student, adotando-se o nível de significância de 5%.RESULTADOS: A atividade quimiotática dos leucócitos polimorfonucleares neutrofílicos de mulheres no pós-parto, na presença de soro homólogo (73,2±6,9) e autólogo (78,6±13,9), mostrou diferença significante quando comparada aos valores observados no Grupo Controle (64,1±4,1 e 66,6±5,4). A resposta quimiotática e a etapa de ingestão da fagocitose por leucócitos polimorfonucleares neutrofílicos apresentaram acréscimos expressivos (p<0,05) em puérperas ao compararem-se aos valores de mulheres saudáveis não gestantes e não puérperas.CONCLUSÃO: Houve um aumento da atividade quimiotática e da resposta fagocitária por leucócitos polimorfonucleares neutrofílicos nos primeiros cinco dias após parto vaginal nas mulheres.

Postpartum Glucose Testing Rates Following Gestational Diabetes Mellitus and Factors Affecting Testing Non-compliance from Four Tertiary Centers in Korea

The purpose of this study was to investigate postpartum glucose testing rates in patients with gestational diabetes mellitus (GDM) and to determine factors affecting testing non-compliance in the Korean population. This was a retrospective study of 1,686 patients with GDM from 4 tertiary centers in Korea and data were obtained from medical records. Postpartum glucose testing was conducted using a 2-hr 75-g oral glucose tolerance, fasting glucose, or hemoglobin A1C test. Test results were categorized as normal, prediabetic, and diabetic. The postpartum glucose testing rate was 44.9% (757/1,686 patients); and of 757 patients, 44.1% and 18.4% had pre-diabetes and diabetes, respectively. According to the multivariate analysis, patients with a high parity, larger weight gain during pregnancy, and referral from private clinics due to reasons other than GDM treatment were less likely to receive postpartum glucose testing. However, patients who had pharmacotherapy for GDM were more likely to be screened. In this study, 55.1% of patients with GDM failed to complete postpartum glucose testing. Considering the high prevalence of diabetes (18.4%) at postpartum, clinicians should emphasize the importance of postpartum diabetes screening to patients with factors affecting testing noncompliance.

Vitamin A, vitamin E, iron and zinc status in a cohort of HIV-infected mothers and their uninfected infants

Introduction We hypothesized that nutritional deficiency would be common in a cohort of postpartum, human immunodeficiency virus (HIV)-infected women and their infants. Methods Weight and height, as well as blood concentrations of retinol, α-tocopherol, ferritin, hemoglobin, and zinc, were measured in mothers after delivery and in their infants at birth and at 6-12 weeks and six months of age. Retinol and α-tocopherol levels were quantified by high performance liquid chromatography, and zinc levels were measured by atomic absorption spectrophotometry. The maternal body mass index during pregnancy was adjusted for gestational age (adjBMI). Results Among the 97 women 19.6% were underweight. Laboratory abnormalities were most frequently observed for the hemoglobin (46.4%), zinc (41.1%), retinol (12.5%) and ferritin (6.5%) levels. Five percent of the women had mean corpuscular hemoglobin concentrations < 31g/dL. The most common deficiency in the infants was α-tocopherol (81%) at birth; however, only 18.5% of infants had deficient levels at six months of age. Large percentages of infants had zinc (36.8%) and retinol (29.5%) deficiencies at birth; however, these percentages decreased to 17.5% and 18.5%, respectively, by six months of age. No associations between infant micronutrient deficiencies ...

Comparação entre a concentração sérica de alfa-tocoferol de puérperas assistidas em maternidades públicas e privadas no Nordeste do Brasil / Comparison between the serum concentration of alpha-tocopherol in puerperal women assisted in public and private maternities in Northeastern Brazil

OBJETIVO: Comparar a concentração de alfa-tocoferol no soro entre puérperas atendidas em maternidades das redes pública e privada da cidade de Natal (RN), Brasil. MÉTODOS: Participaram do estudo 209 puérperas, sendo 96 mulheres provenientes da rede privada e 113, da rede pública, entre 24 e 48 horas pós-parto. Foram incluídas no estudo parturientes com idade a partir de 12 anos, sem patologias associadas à gestação, que tiveram concepto único sem má-formação. Mulheres descompensadas clinicamente e com gestação múltipla foram excluídas. Amostras de 5 mL de sangue de cada participante foram coletadas no período de jejum, antes da primeira refeição do dia. A concentração de alfa-tocoferol no soro (µg/dL) foi determinada por cromatografia líquida de alta eficiência (CLAE). A diferença estatística entre as médias foi testada utilizando o teste t de Student. RESULTADOS: As médias da concentração de alfa-tocoferol nas puérperas da rede pública e da rede privada, respectivamente, foram 1.115,7±341,4 μg/dL e 1.355,7±397,6 μg/dL, tendo sido observada diferença estatisticamente significante (p=0,000687). Para avaliação individual da concentração de vitamina E, a deficiência foi identificada quando alfa-tocoferol <11,6 μmol/L ou <499,6 µg/dL. As puérperas da rede pública tiveram um percentual de 5,3% (n=6) de deficiência, enquanto nas participantes da rede privada tal carência não foi encontrada. Todavia, baixas concentrações (alfa-tocoferol entre 11,6-16,2 μmol/L ou 499,6-697,7 µg/dL) ocorreram tanto na rede pública como na privada: 9,7% (n=11) e 4,2% (n=4), respectivamente. CONCLUSÃO: Esses resultados destacam que as mulheres assistidas ...

PURPOSE: To compare the concentration of serum alpha-tocopherol during the postpartum period in women admitted to public and private hospitals in Natal (RN), Brazil. METHODS: The study included 209 women in the postpartum period, 96 of them from private hospitals and 113 from public hospitals, studied between 24 and 48 hours postpartum. Inclusion criteria were: mothers aged 12 years or more, without diseases associated with pregnancy, who had given birth to a singleton with no malformations. Clinically decompensated women with multiple fetuses were excluded. A 5 mL blood sample was obtained from each participant under fasting conditions, before the first meal of the day. The concentration of alpha-tocopherol in serum (µg/dL) was determined by high performance liquid chromatography (HPLC). The statistical difference between means was tested by the Student's t-test. RESULTS: The mean concentration of alpha-tocopherol was 1.115.7 µg/dL in puerperae from the public network and 1.355.7±397.6 µg/dL in puerperae from the privte network , with a significant difference between groups (p=0.000687). Vitamin E concentration was determined individually and an alpha-tocopherol level <11.6 µmol/L or <499.6 µg/dL was considered to indicate deficiency. Vitamin E deficiency was detected in 5.3% of puerperae from the public network (n=6), whereas no deficiency was detected among women from the private network. However, low concentrations of alpha-tocopherol (11.6 to 16.2 µmol/L or 499.6 to 697.7 µg/dL) was detected in both groups, i.e., in 9.7% of the women from the public network (n=11) and in 4.2% for the women from the private network (n=4). CONCLUSION: These results highlight that women assisted in the public sector were more vulnerable to developing low concentrations of alpha-tocopherol than women assisted in the private sector. .

Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescentes en su primer año posparto / Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum

La información sobre biomarcadores óseos en adolescentes y adultas durante el periodo posparto es incierta, por lo que el objetivo de este artículo fue analizar el patrón de biomarcadores óseos en adolescentes y adultas a 15, 90, 180 y 365 días posparto (dpp) y su asociación con la densidad mineral ósea (DMO) y lactancia materna. Se realizó un estudio de cohorte en 32 madres adolescentes ≤17 años y 41 adultas de 18 a 29 años de edad en el primer año posparto. Se realizaron medidas antropométricas, DMO y biomarcadores óseos y así como datos del tipo y la duración de lactancia. Como resultados se encontró asociación entre la concentración basal de N-telopéptidos ≤24 μg/L y mayor aumento de DMO. Las adolescentes tuvieron mayor concentración de N-telopéptidos (p≤0.004) y menor concentración de osteocalcina (5±3 vs13±4, p <0.001) que las adultas. La lactancia no afectó el cambio de DMO (p>0.050), ni de biomarcadores óseos. La osteocalcina se asoció con el cambio en DMO (p<0.040). La prolactina fue mayor entre las que practicaron lactancia materna exclusiva (p<0.001). A menor edad menores concentraciones de osteocalcina (p<0.001) y mayores concentraciones de N-telopéptidos (p<0.001). Se concluyó que a menor concentración de N-telopéptidos y mayor de osteocalcina hubo un mayor aumento de DMO, lo cual implica menor aumento de ésta en el grupo de adolescentes. La lactancia no afectó la DMO.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager’s ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.

Postpartum glucose tolerance status 6 to 12 weeks after gestational diabetes mellitus: a Brazilian cohort / Reavaliação do estado glicêmico 6 a 12 semanas após o diabetes melito gestacional: uma coorte brasileira

Objectives: The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Subjects and methods: Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Results: Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n = 14), OGTT (n = 93) or random glucose (n = 1). Return was associated with lower parity rate (2 vs. 3, p < 0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p = 0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk - RR 2.41, p = 0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p = 0.045), insulin use during pregnancy (RR 2.37, p = 0.014), and cesarean section (RR 2.61, p = 0.015). Conclusions: Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia. Arq Bras Endocrinol Metab. 2014;58(2):197-204 .

Objetivos: Os objetivos foram estimar a taxa de reavaliação de diabetes pós-parto em mulheres com diabetes melito gestacional (DMG) e identificar fatores associados ao retorno e à persistência das alterações glicêmicas. Sujeitos e métodos: Coorte prospectiva de mulheres com DMG atendidas em ambulatório de pré-natal especializado, de novembro de 2009 a maio de 2012. Todas foram orientadas a agendar o teste oral de tolerância à glicose (TOTG) a partir da sexta semana pós-parto. Resultados: Das 209 mulheres arroladas na gestação, 108 (51,7%) foram avaliadas após o parto: 14 com glicemia de jejum, 93 com o TOTG e uma com glicemia ao acaso. O retorno para reavaliação foi associado com menor paridade (2 vs. 3, p < 0,001) e com glicemia de 2-h mais elevada no TOTG diagnóstico (165 vs. 155 mg/dL, p = 0,034). Diabetes foi diagnosticado em quatro mulheres (3,7%) e pré-diabetes em 22 (20,4%). Análise multivariada evidenciou que a história familiar de diabetes (risco relativo – RR 2,41, p = 0,050), a glicemia de 2 horas no TOTG da gestação (RR 1,01, p = 0,045), o uso de insulina na gestação (RR 2,37, p = 0,014) e a taxa de cesariana (RR 2,61, p = 0,015) foram os fatores associados à persistência da hiperglicemia. Conclusões: O retorno para reavaliação foi baixo, embora as alterações glicêmicas tenham sido frequentes. Como não houve fatores que indiquem quais mulheres retornarão, estratégias para aumentar a adesão são necessárias, especialmente quando há história familiar ou o DMG foi mais grave. Arq Bras Endocrinol Metab. 2014;58(2):197-204 .

Serum Magnesium Level Is Associated with Type 2 Diabetes in Women with a History of Gestational Diabetes Mellitus: The Korea National Diabetes Program Study

Gestational diabetes mellitus (GDM) is a strong predictor of postpartum prediabetes and transition to overt type 2 diabetes (T2DM). Although many reports indicate that low magnesium is correlated with deteriorated glucose tolerance, the association between postpartum serum magnesium level and the risk for T2DM in women with a history of GDM has not been evaluated. We analyzed postpartum serum magnesium levels and development of prediabetes and T2DM in women with prior GDM according to American Diabetes Association (ADA) criteria using the Korean National Diabetes Program (KNDP) GDM cohort. During a mean follow-up of 15.6+/-2.0 months after screening, 116 women were divided into three groups according to glucose tolerance status. Ultimately, eight patients (6.9%) were diagnosed with T2DM, 59 patients (50.9%) with prediabetes, and 49 patients (42.2%) with normal glucose tolerance (NGT) after follow-up. The T2DM group had the lowest serum magnesium level (0.65 [0.63-0.68] mM/L) in the postpartum period, but there was no significant difference between the prediabetes group (0.70 [0.65-0.70] mM/L) and the NGT group (0.70 [0.65-0.70] mM/L) (P=0.073) Multiple logistic regression analysis showed that postpartum HOMA-IR was a significant predictor of both prediabetes and T2DM. Moreover, we found that postpartum serum magnesium level was also a possible predictor for T2DM development. Serum magnesium level in the postpartum period may be a possible predictor for T2DM development in women with a history of GDM.

Las adolescentes no pierden densidad mineral ósea en el posparto: estudio comparativo con adultas / Adolescents do not lose bone mineral density postpartum: comparative study with adult women

OBJETIVO: Analizar el patrón de la densidad mineral ósea (DMO), calcio y estradiol séricos, consumo de calcio, índice de masa corporal (IMC) y lactancia en adolescentes y adultas a 15, 90 y 365 días posparto (dpp). MATERIAL Y MÉTODOS: Cohorte prospectivo en 33 adolescentes y 39 adultas con evaluación antropométrica, dietética y ósea en L2-L4 y cuello de fémur; bioquímica con estradiol y calcio séricos. RESULTADOS: Las adolescentes aumentaron de los 15 a los 365 dpp 16 por ciento su DMO de L2-L4, las adultas 3 por ciento. La edad se asoció a este cambio (β=13.779, EE=3.5, p=0.001); la lactancia no se asoció (β=-0.705, EE=0.647, p=0.283). Las adultas presentaron mayor DMO de L2-L4 a 15, 90 y 365 dpp respectivamente (1.151vs 0.978g/cm², 1.195vs1.070g/cm², 1.195vs1.123g/cm², p<0.003). CONCLUSIONES: Las adolescentes incrementaron su DMO tres veces más que las adultas. El cambio en la DMO fue dependiente de la edad e independiente de la práctica de lactancia.

OBJECTIVE: To analyze the pattern of bone mineral density (BMD), serum concentrations of estradiol and calcium levels, dietary calcium, body mass index (BMI), and lactation in adolescents and adult women at 15, 90, and 365 postpartum days (ppd). MATERIAL AND METHODS: A prospective cohort study was conducted of 33 adolescents and 39 adult women. Anthropometric and dietetic evaluations were performed, as well as evaluations of bone mineral density in L2-L4 and femur neck. Estradiol concentrations and calcium serum levels were determined. RESULTS: L2-L4 BMD increased by 16 percent in adolescents, and 3 percent in adult women from day 15 to 365 ppd. While age was associated with this change (β=13.779, EE=3.5, p=0.001), lactation was not (β=-0.705, EE=0.647, p=0.283). The adult women had a higher L2-L4 BMD at 15, 90, and 635 ppd (1.151 vs 0.978g/cm², 1.195 vs 1.070g/cm², 1.195 vs 1.123g/cm², respectively) (p<0.003). CONCLUSIONS: Adolescents' BMD increased three times more than that of adult women. For all women, BMD was dependent of age and independent of lactation.

Influência da gestação e do puerpério no lipidograma de bovinos da raça Holandesa / Influence of gestation and puerperium on the lipid profile of Holstein cattle

Avaliou-se a influência da gestação e do puerpério no lipidograma de bovinos da raça Holandesa por meio da determinação de colesterol, triglicérides, ácidos graxos não esterificados (AGNE), β-hidroxibutirato (β-HBO) e glicose em 80 amostras de soro e plasma sangüíneo. Os animais foram distribuídos em cinco grupos (G) experimentais: G1 - constituído por 16 fêmeas não prenhes; G2 -18 fêmeas na fase inicial da gestação (com até três meses); G3 - 15 fêmeas prenhes, entre três e seis meses de gestação; G4 - 15 fêmeas na fase final da gestação (entre seis e nove meses); G5 - 16 fêmeas recém-paridas, com até 30 dias de puerpério. Houve influência da gestação sobre o lipidograma, pois os teores séricos de AGNE foram mais altos no terço final da gestação, enquanto os teores séricos de β - HBO foram mais elevados durante o terço inicial de gestação. O puerpério influenciou os constituintes do lipidograma, pois, nos primeiros 30 dias após a parição, os teores séricos de AGNE e β - HBO foram mais altos, enquanto os de triglicérides foram mais baixos nos animais no puerpério em relação aos que estavam em gestação.

In order to establish the influence of gestation and puerperium on the lipid profile of Holstein cattle, the concentrations of cholesterol, triglycerides, nonesterified fatty acids (NEFA), β-hydroxibutyrate (β-HBO), and glucose were determined in samples of serum and plasma from 80 animals distributed into five experimental groups (G): G1 - 16 non pregnant females; G2 - 18 females in the initial phase of gestation, up to three months; G3 -15 pregnant females, with gestation from three to six months; G4 - 15 females in the last stage of gestation, from six to nine months; G5 - 16 females soon after delivering, up to 30 days in puerperium. The lipid profile of healthy Holstein cows was influenced by gestation. The concentration of NEFA was higher in the last trimester of gestation while the serum concentration of β-HBO was higher in the first trimester of gestation. In the first 30 days after delivering, the concentrations of NEFA and β-HBO were higher, while those of triglycerides were lower when compared to those of cows during gestation.