Effects of perineal massage at different stages on perineal and postpartum pelvic floor function in primiparous women: a systematic review and meta-analysis.

BACKGROUND: Perineal massage, as a preventive intervention, has been shown to reduce the risk of perineal injuries and may have a positive impact on pelvic floor function in the early postpartum period. However, there is still debate concerning the best period to apply perineal massage, which is either antenatal or in the second stage of labor, as well as its safety and effectiveness. Meta-analysis was used to evaluate the effect of implementing perineal massage in antenatal versus the second stage of labor on the prevention of perineal injuries during labor and early postpartum pelvic floor function in primiparous women. METHODS: We searched nine different electronic databases from inception to April 16, 2024. The randomized controlled trials (RCTs) we included assessed the effects of antenatal and second-stage labor perineal massage in primiparous women. All data were analyzed with Revman 5.3, Stata Statistical Software, and Risk of Bias 2 was used to assess the risk of bias. Subgroup analyses were performed based on the different periods of perineal massage. The primary outcomes were the incidence of perineal integrity and perineal injury. Secondary outcomes were perineal pain, duration of the second stage of labor, postpartum hemorrhage, urinary incontinence, fecal incontinence, and flatus incontinence. RESULTS: This review comprised a total of 10 studies that covered 1057 primigravid women. The results of the analysis showed that perineal massage during the second stage of labor reduced the perineal pain of primigravid women in the immediate postpartum period compared to the antenatal period, with a statistical value of (MD = -2.29, 95% CI [-2.53, -2.05], P < 0.001). Additionally, only the antenatal stage reported that perineal massage reduced fecal incontinence (P = 0.04) and flatus incontinence (P = 0.01) in primiparous women at three months postpartum, but had no significant effect on urinary incontinence in primiparous women at three months postpartum (P = 0.80). CONCLUSIONS: Reducing perineal injuries in primiparous women can be achieved by providing perineal massage both antenatally and during the second stage of labor. Pelvic floor function is improved in the postnatal phase by perineal massage during the antenatal stage. TRIAL REGISTRATION: CRD42023415996 (PROSPERO).

Depression in the Perinatal Period: Course and Outcome of Depression in the Period from the Last Trimester of Pregnancy to One Year after Delivery in Primiparous Mothers.

Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month' postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options.

Effects of parity and week after calving on the metabolic, redox and immune status of dairy cows.

At the onset of lactation in dairy cows, inflammation and oxidative stress may occur and result in a risk of pathologies and lower milk yield. To propose an innovative management strategy for cows during this period, it is essential to better understand these physiological variations. Our objective was to evaluate the metabolic, redox and immune status of 7 primiparous and 8 multiparous Holstein cows during late gestation and the first months of lactation. Blood samples were collected between 3 weeks before calving until 12 weeks postpartum. Milk samples were also collected, but only at the time points after calving. The metabolic (nonesterified fatty acids (NEFA), BHB, glucose, urea, calcium) and redox (reactive oxygen metabolites (ROM), oxidative stress index (OSI), glutathione peroxidase activity, vitamin E) statuses were analyzed in plasma or erythrocytes. The expression of genes related to antioxidant functions was determined in leukocytes collected from milk. For immune status, plasma cytokine levels and the production of reactive oxygen species (ROS) in classical and regulatory neutrophils were measured in 2 whole blood ex vivo challenges. The data were analyzed using a mixed model that included the fixed effects of parity and week and their interaction. Milk yield, plasma NEFA and BHB in wk 2 and 4 after calving were higher in multiparous cows than in primiparous cows, whereas glucose and calcium tended to be lower. Plasma ROM and OSI levels in wk 8 were higher in multiparous than in primiparous cows. Multiparous cows also displayed higher glutathione peroxidase activity in erythrocytes, and antioxidant transcription factor and superoxide dismutase-1 expression levels in milk leukocytes. Moreover, multiparous cows had higher plasma concentrations of vitamin E but lower plasma levels of cytokines CXCL10, CCL2, IL1Rα and IFNγ. Following ex vivo whole blood stimulation with Escherichia coli, lower IL1α and TNFα levels were measured in multiparous than in primiparous cows. Intracellular ROS production by neutrophils was lower in multiparous than in primiparous cows. These results thus indicated marked physiological changes in wk 8 compared with wk 2 and 4 of lactation. These differences in the physiological status of primiparous and multiparous cows offer interesting perspectives for potential dietary strategies to prevent pathologies which take account of parity and week relative to calving.

Enhancement of selectivity, 25-hydroxyvitamin D3 level, alkaline phosphatase activity and reproductive performance in gilts and primiparous sows using 14-epimer of 25-hydroxyvitamin D3.

Selecting breed-worthy gilts as sow replacements is essential for continuity of pig production cycle. Though vitamin D3 (VD3) is known to enhance reproductive performance of multiparous sows, there is still a knowledge gap on its impact in developing gilts and primiparous sows. This study was aimed to quantify plasma 25-hydroxyvitamin D3 (25(OH)D3), serum alkaline phosphatase (ALP), and examine the reproductive performance of primiparous sows fed diets supplemented with regular VD3, and its 25(OH)D3 epimers. The study sample comprised 10-week-old replacement gilts (50 % Landrace x 50 % Yorkshire, N = 180) assigned in a randomized complete block design to three treatments [2,000 IU/kg of VD3 (T1), 25 µg/kg of 14­epi-25(OH)D3, half dose (T2), and 50 µg/kg of 25(OH)D3 (T3)] equilibrated to 2,000 IU/kg in base diets. Selections occurred at 22, 27 and 35 weeks of age, respectively. Plasma 25(OH)D3, serum alkaline phosphatase (ALP), bone structure and reproductive performance were analyzed. Dietary treatments influenced carpus (P = 0.023), fore view stance (P = 0.017), infantile vulva (P = 0.014), inverted (P = 0.048), and prominent teat (P < 0.001). Post-partum 25(OH)D3 concentration and ALP activity were elevated by day 25 (P < 0.001). Treatment diets also influenced total born (P < 0.001), born alive (P = 0.048), and still born (P = 0.049). Two factors affect circulating 25(OH)D3 and ALP activity: physiological changes in sows during lactation, and dietary 25(OH)D3 intake. 14­epi-25(OH)D3 is a potent metabolite for improving maturation of reproductive organs in developing gilts. It also reduces still birth in primiparous sows.

Body image perceptions of pregnant women in the third trimester in Turkey: A qualitative study.

RATIONALE: Body image undergoes significant changes during pregnancy, marking a pivotal phase in a woman's life. AIM AND OBJECTIVE: This study aimed to explore the body image perceptions of primiparous pregnant women during their third trimester. METHODS: Employing a qualitative research approach grounded in phenomenology, the study involved interviews to explore the experiences of primiparous pregnant women in their third trimester. The interviews were conducted via an online platform, with a sample group of 13 participants chosen through purposive sampling. Data analysis followed a content analysis approach, with the information being transferred to MAXQDA Analytics Pro Qualitative Data Analysis Programme for coding. The study adhered to the reporting guidelines outlined in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: Systematic analysis of the interview transcripts led to the identification of three main themes under the overarching framework of body image experiences among primiparous pregnant women during the third trimester: Physical Changes, Mental Changes, and Behavioural and Social Changes. Among the identified themes, pregnant women demonstrated a relatively lower level of discourse regarding Physical Changes, in contrast to a significant emphasis on Mental Changes. Within the latter theme, pregnant women exhibited significant dissatisfaction with their pregnancy experiences significantly. CONCLUSION: It was determined that pregnant women experience physical and psychological changes related to body image during pregnancy.

Using mobile health in primiparous women: effect on awareness, attitude and choice of delivery type, semi-experimental.

BACKGROUND: One of the reasons for the increase in cesarean section is the lack of knowledge of mothers in choosing the type of delivery. The present study aimed to determine the effect of education through pregnancy application during pregnancy on awareness and attitude and choice of delivery type in primiparous women at Shahid Alavi Specialized Medical Center clinic in Mashhad. METHODS: This study was a semi-experimental type. Seventy primiparous pregnant women who had no restrictions for birth was selected. Sampling was randomized and purpose-based. The data collection tool was a questionnaire. The starting time of the training was considered from the end of the 27th week of pregnancy and continued with regular intervals until the end of the pregnancy. The questionnaires were completed once before the training and once after the training as a pre-test and post-test by the research units. SPSS software (version 26) and MacNemar test and descriptive statistics were used for data analysis. RESULTS: According to the results of the MacNemar test, a significant statistical difference was seen between women's knowledge and attitude after the training compared to before (p-value < 0.01). Choosing the type of birth was preferred before and after the training. But following the performance of women showed that only 62.86% of them chose natural birth. In fact, before the training, 40% and after 72.86% of women had chosen birth. CONCLUSION: Pregnancy education and application during pregnancy is effective in reducing the choice of cesarean section, so this application with the topic of birth and cesarean section has improved the level of attitude and also the positive attitude of pregnant women towards birth. Creation of facilities and promotion of different methods of painless childbirth and training of maternity staff to perform birth is expected.

Effects of Growth Hormone-Releasing Hormone (GHRH) Plasmid Treatment on the Reproductive Productivity of Sows in Primiparous and Multiparous Sow Breeds.

The effect of growth hormone-releasing hormone (GHRH) plasmid treatment on sow reproductive performance was examined. Forty pregnant sows (three-way crossbreed: Landrace × Yorkshire × Duroc) at 85 days of gestation were included in the study and consisted of twenty primiparous and twenty multiparous sows (third parity). Sows were randomly assigned to the control and treatment groups. The treatment group received 5 mg dose of GHRH plasmid injection via electroporation, whereas the control group received a phosphate buffer solution. Reproductive indicators, including serum insulin-like growth factor-1 (IGF-1) concentration and weaned piglet data, were assessed. In the GHRH plasmid-treated group, serum IGF-1 concentration significantly increased compared with that in the control group, a trend observed in primiparous and multiparous sows. The key indicator of reproductive performance, litter size, showed that for control primiparous sows (C-PS), it was 10.90 ± 0.99 kg, while for control multiparous sows (C-MS), it was 14.00 ± 0.67 kg. Furthermore, for primiparous sows treated with GHRH plasmid (G-PS), the litter size was 11.60 ± 0.97 kg, and for multiparous sows treated with GHRH plasmid (G-MS), it was 14.00 ± 0.82 kg. The GHRH plasmid-treated group also exhibited a higher number of total births and surviving piglet numbers, along with a decrease in stillborn piglets; however, there was no significant difference in birth weight. The results suggest that GHRH plasmid treatment can enhance the reproductive performance of sows.

Combined Metabolomics and Biochemical Analyses of Serum and Milk Revealed Parity-Related Metabolic Differences in Sanhe Dairy Cattle.

The production performance of dairy cattle is closely related to their metabolic state. This study aims to provide a comprehensive understanding of the production performance and metabolic features of Sanhe dairy cattle across different parities, with a specific focus on evaluating variations in milk traits and metabolites in both milk and serum. Sanhe dairy cattle from parities 1 to 4 (S1, n = 10; S2, n = 9; S3, n = 10; and S4, n = 10) at mid-lactation were maintained under the same feeding and management conditions. The milk traits, hydrolyzed milk amino acid levels, serum biochemical parameters, and serum free amino acid levels of the Sanhe dairy cattle were determined. Multiparous Sanhe dairy cattle (S2, S3, and S4) had a greater milk protein content, lower milk lactose content, and lower solids-not-fat content than primiparous Sanhe dairy cattle (S1). Moreover, S1 had a higher ratio of essential to total amino acids (EAAs/TAAs) in both the serum and milk. The serum biochemical results showed the lower glucose and total protein levels in S1 cattle were associated with milk quality. Furthermore, ultra-high-resolution high-performance liquid chromatography with tandem MS analysis (UPLC-MS/MS) identified 86 and 105 differential metabolites in the serum and milk, respectively, and these were mainly involved in amino acid, carbohydrate, and lipid metabolism. S1 and S2/S3/S4 had significantly different metabolic patterns in the serum and milk, and more vitamin B-related metabolites were significantly higher identified in S1 than in multiparous cattle. Among 36 shared differential metabolites in the serum and milk, 10 and 7 metabolites were significantly and strongly correlated with differential physiological indices, respectively. The differential metabolites identified were enriched in key metabolic pathways, illustrating the metabolic characteristics of the serum and milk from Sanhe dairy cattle of different parities. L-phenylalanine, dehydroepiandrosterone, and linoleic acid in the milk and N-acetylornithine in the serum could be used as potential marker metabolites to distinguish between Sanhe dairy cattle with parities of 1-4. In addition, a metabolic map of the serum and milk from the three aspects of carbohydrates, amino acids, and lipids was created for the further analysis and exploration of their relationships. These results reveal significant variations in milk traits and metabolites across different parities of Sanhe dairy cattle, highlighting the influence of parity on the metabolic profiles and production performance. Tailored nutritional strategies based on parity-specific metabolic profiles are recommended to optimize milk production and quality in Sanhe cattle.

Factors associated with perineal pain on the first postnatal day after vaginal delivery: a cross-sectional study of primiparous women.

Many women report postpartum perineal pain due to perineal trauma after vaginal delivery. Perineal pain after giving birth declines over time; however, perineal trauma and pain negatively impact on the women's quality of life and their ability to care for their children. The degree of perineal trauma and instrument delivery with episiotomy are associated with perineal pain. Nevertheless, no studies have examined factors related to postpartum perineal pain, including weight changes during pregnancy as well as the course of delivery so far. We aimed to elucidate obstetric factors associated with perineal pain after vaginal delivery on the first postnatal day in Japanese primiparous women. A cross-sectional study conducted in five maternity hospitals in Japan included 142 primiparous women who vaginally delivered full-term and singleton infants. Perineal pain on the first postnatal day was evaluated using a visual analog scale. The final analysis included 92 participants with a mean age of 30.3 ± 4.6 years. The median visual analog scale score was 54.0 mm. Multiple linear regression analysis demonstrated that gestational weight gain above the recommended Japanese range was positively and significantly associated with perineal pain on the first postnatal day, independent of maternal age, episiotomy, painkiller use, and neonatal birth weight. This finding may provide additional evidence regarding gestational weight gain within the recommended range based on the pre-pregnancy body mass index to reduce perineal pain on the first postnatal day.

Effects of equine chorionic gonadotropin dosage and its splitting in different days on reproductive performance of Nellore cows synchronized for timed-artificial insemination.

This study evaluated the effects of dose of equine chorionic gonadotropin (eCG) and its splitting in different days of the synchronization protocol on reproductive performance of primiparous and multiparous Nellore cows. In the present study, 2,536 Nellore cows (1,634 primiparous and 902 multiparous) were assigned to receive in a 2 × 2 factorial design 1) an intravaginal progesterone (P4) device and 2.0 mg of estradiol benzoate (EB) on day -11, 12.5 mg (i.m.) of dinoprost tromethamine (PGF), 300 IU (i.m.) of eCG, 0.6 mg (i.m.) of estradiol cypionate (ECP), and P4 device withdrawal on day -2, followed by TAI on day 0 (n = 632 cows, being 409 primiparous and 223 multiparous; 300-2), 2) 300 IU (i.m) of eCG administered on days -4 and -2 (150 IU of eCG/day; n = 637 cows, being 412 primiparous and 225 multiparous; 300-4-2), 3) 400 IU (i.m.) of eCG administered on day -2 (n = 633 cows, being 406 primiparous and 227 multiparous; 400-2), and 4) 400 IU (i.m) of eCG administered on days -4 and -2 (200 IU of eCG/day; n = 634 cows, being 407 primiparous and 227 multiparous; 400-4-2). Individual cow BCS was assessed on days -11, 0 (timed-AI), and 31 of the study. Body condition score of the animals was classified into LOW or HIGH using the threshold of 2.75 (≤2.75 = LOW; >2.75 = HIGH). For primiparous cows, an eCG splitting effect was observed on follicle size, as cows receiving eCG on days -4 and -2 of the synchronization protocol had a larger follicle than cows administered eCG only on day -2. For day 31 P/AI, primiparous cows receiving 400-4-2, regardless of BCS, had a greater P/AI than cows from other treatments. Administering 400-4-2 to LOW BCS cows also resulted in greater P/AI than all other treatments assigned to LOW BCS cows. For multiparous cows, no treatment effect was observed for follicle size, estrus expression, and day 31 P/AI (P ≥ 0.21). In summary, increasing the dose and splitting the dose of eCG positively impacted the pregnancy rates of primiparous cows under a BCS ≤2.75, but no effects were detected on multiparous cows.

Lactation performances in primiparous Holstein cows following short and normal gestation lengths.

Despite decades of research, little is known regarding physiologic temporal limits for initiation of lactation in pregnant non-lactating cattle the aim of this study was to compare the lactation performances in primiparous Holstein cows after a short gestation length (GL) or abortion to those after a normal GL. The data were collected using an automated data collection system. The 94 herds evaluated were located in Belgium, France, Italy, the Netherlands and Germany. Data from a wide range of physiological cow-life events including birth and calving events, reproduction events (insemination, pregnancy checks, and abortions), and milking events were collected. The GL was defined as the interval between the last insemination and the subsequent calving (or abortion) within a range of 150-297 days. Animals were categorized into one of five categories based on GL quantiles (C-I to C-V). Lactation curve parameters including the scale, ramp, and decay were estimated using the Milkbot model. Then, the derived 305-day milk yield (M305-d), peak yield, and time to peak were compared between different GL categories. Of 13,732 lactations, 15 (0.11%) were found with a GL shorter than 210 days (ranging from 158 to 208 days). The 305-day milk yield was significantly lower in the C-I (7,566 ± 186) and C-II groups (7,802 ± 136 kg), compared to the C-III (8,254 ± 116 kg), C-IV (8,148 ± 119 kg), and C-V (8,255 ± 117 kg) groups. The same trends were found for the scale and peak yield of the lactation; the lowest scale were found for the C-I (31.5 ± 0.73) and C-II (32.8 ± 0.53) groups, and the highest were found for the C-III (34.5 ± 0.46), C-IV (34.9 ± 0.45), and C-V (35.0 ± 0.45) groups. Peak yield increased significantly from C-I (27.8 ± 0.66 kg) and C-II group (28.8 ± 0.48 kg) to the C-III (30.2 ± 0.42 kg) and further to the C-IV (30.6 ± 0.40 kg) and C-V (30.6 ± 0.41 kg) groups. Moreover, primiparous cows in the C-II GL category showed a higher milk yield persistency (decay of 1.30E-4 ± 3.55E-5) compared to those belonging to the C-IV (decay of 1.38E-4 ± 2.51E-5) and C-V (decay of 1.38E-4 ± 2.58E-5) group. In conclusion, results showed that primiparous cows with a shorter GL produced significantly less 305-day milk and peak yields, had a higher lactation persistency, and showed a lower upward slope of the lactation curve compared to those with a normal GL.

The effect of the training provided to primiparous pregnant women based on the model on pregnancy risk perception and health literacy.

The purpose of this study was to assess the impact of health education based on the health belief model (HBM) on the perception of risk in pregnancy and health literacy in primiparous pregnant women to maintain and improve their health. The study was carried out with 82 pregnant women who were in the second trimester. The number of samples was calculated using the G-Power program version 3.1.7. The number of samples was found 44 for the education group and 44 for the control group with a confidence interval of 95 percent, a margin of error of 5 percent, a large Cohen d effect size value (0.5), and a power of 80 percent. Randomization was performed using the envelope method to determine the interventional and control groups. The training prepared in line with the SIM was presented to the participants in the education group. 2 sessions per week, a total of 4 times. "Personal Information Form," Health Literacy Scale (HLS), and Perception of Pregnancy Risk Questionnaire (PPRQ) were used as data collection tools. The mean of the risk perception of the pregnant toward the baby posttest score was 9.95 ± 13.30 in the education group, and 23.35 ± 21.41 in the control group (p = .001). The mean health literacy scale posttest score was 103.52 ± 19.77 in the education group and 93.5 ± 19.02 in the control group, and it was found to be statistically significantly higher in the health literacy education group than in the control group (p = .027). This study found that educating pregnant women using the health belief model reduces their risk perception and boosts their degree of health literacy.

Electroencephalographic activity during direct breastfeeding and breast milk expression in primiparous mothers.

Breastfeeding is recognized worldwide as the best option for infant feeding. Expressing breast milk is an alternative for mothers to provide their infants all the benefits of maternal milk. During breast milk expression, mothers receive a distinct kind of sensory stimulation, because there is no direct bodily or affective interaction with their infants, many women report feeling isolated, generating a love-hate relation with pumping, and even low levels of satisfaction while expressing breast milk. While it is well known that the prefrontal, parietal, and temporal cortices play important roles in the emotional and cognitive processing of maternal stimuli, knowledge about how these cortical areas function during breastfeeding is lacking. This study was designed to characterize EEG activity in the prefrontal and parietal cortices and the affective scores of primiparous breastfeeding mothers during two conditions of milk expression: breast milk expression and direct breastfeeding. Participants reported higher valence and arousal and a pleasant state during direct breastfeeding. In the direct breastfeeding condition, both prefrontal areas showed a higher absolute power (AP) of the slow bands, with a lower AP of the alpha band in the parietal cortex. A lower correlation between frontopolar and dorsolateral areas with a higher correlation between prefrontal and parietal cortices was obtained mainly in the right hemisphere. This EEG activity could be linked to an internal state of focused attention and, simultaneously, open monitoring of the environment that suggests an integration of the motive-emotional and cognitive processes necessary for adequate mother-baby interaction during direct breastfeeding.

Fetal programming effect of rumen-protected methionine on primiparous Angus × Simmental offspring's performance and skeletal muscle gene expression.

Primiparous Angus × Simmental dams (n = 22) with an average body weight (BW) of 449 ±â€…32 kg of BW were divided based on two nutritional treatments: control (CTRL) and rumen-protected methionine (RPM). The control group received bermudagrass hay, corn gluten, and soybean hulls pellets supplementation (base diet); whereas the RPM group received the base diet in addition to 0.07% of DM of RPM at a fixed rate during the last trimester of gestation and the first ~80 d of lactation, in which calves (n = 17) were early weaned. Only male calves were included in this study. After weaning, calves born to RPM dams also received RPM from weaning (day 1) to day 100. Blood sampling and skeletal muscle biopsies for subsequent quantitative polymerase chain reaction (PCR) analysis were conducted on days 1, 25, 50, and 100 on calves. Quantitative PCR data were analyzed using GLIMMIX, and blood metabolites concentrations, BW, and body condition score (BCS) were analyzed using the MIXED procedure of SAS. There was no difference in maternal BW and BCS between treatments. Glucose and blood metabolites that served as biomarkers for liver health (e.g., aspartate transaminase, albumin, alkaline phosphatase, and alanine transaminase) were in the normal levels for all calves (P > 0.40). Calves in the RPM group had a greater expression of adipogenic genes (e.g., PPARG, LPL, and CEBPD) at day 100 compared with CTRL (P < 0.01). In addition, DNA methylation (DNMT1) and oxidative stress-related genes (SOD2 and NOS3) in the RPM group were upregulated at day 100 compared with CTRL (P < 0.01). These results may suggest that calves born to primiparous dams exposed to RPM supplementation are more prone to develop greater adipose tissue than CTRL calves. Furthermore, RPM supplementation may improve methylation processes, as shown by the upregulation of DNMT1. The results shown in our study aim at expanding the knowledge on fetal programming and early-life growth and development of beef cattle under supplementation with RPM.

Plane of nutrition plays a critical role in fetal and postnatal growth in beef cattle offspring. Methionine, a limiting amino acid in ruminants, is also involved in DNA methylation due to its role as S-adenosyl methionine precursor. A complete randomized design experiment was conducted to assess the fetal programming effect of rumen-protected methionine (RPM) supplementation on beef cattle. Calves born to primiparous beef heifers, that individually received RPM during the last trimester of gestation and lactation, had a greater expression of genes related to adipose tissue development, oxidative stress, and DNA methylation compared with those born to dams that did not receive rumen-protected supplementation. No difference in animal performance or blood parameters that serve as biomarkers for liver health status was detected. Our results suggest that maternal supplementation with RPM during the last trimester of gestation and lactation, and supplementation to the offspring after early weaning, could potentially increase adipose tissue development on male calves.

Evaluation of pelvic structural abnormalities in primiparous women with stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the morphological characteristics of pelvic floor structure specific to de novo stress urinary incontinence (SUI) in primiparous women using three-dimensional (3D) reconstruction fusion technology based on static MRI combined with dynamic MRI. METHODS: Eighty-one primiparous women after the first vaginal delivery were studied, 40 with SUI and 41 without SUI. 3D reconstruction models based on static MRI were used to describe the anatomical abnormalities of pelvic floor tissues. Dynamic MRI was used to describe segmental activities of the urethra and vagina. The relationship between the morphometry and postpartum SUI was evaluated by logistic regression analysis and receiver operator characteristic curve. RESULTS: The differences in the distance from the bladder neck to the pubic symphysis (BSD), the angle between the posterior wall of the urethra and the anterior wall of the vagina, the width of the distal region of the vagina, urethral length, urethral compression muscle volume (CUV), and pubovisceral muscle volume, puborectal muscle volume, were measured, and except for the extremity of the anterior urethral wall, the total displacements (TDs) of the other sites between the two groups were statistically significant (p < 0.05). Logistic regression analysis showed that the BSD decreased, the CUV decreased, the TDs of the first site and the eighth site increment correlated significantly with postpartum SUI occurrence (p < 0.05). CONCLUSIONS: 3D reconstruction fusion technology provides an important support for a precise assessment of the pelvic floor dysfunction. The BSD, CUV, and iliococcygeus muscle volume have certain values in predicting de novo SUI after first vaginal birth.

The Importance of Personal and Familial Factors on Breastfeeding Intention and Practices, and Postpartum Distress during the Pandemic: A Longitudinal Observational Study.

BACKGROUND: The COVID-19 pandemic has significantly impacted pregnant and breastfeeding women. Both low- and high-risk groups adopted preventive approaches such as mask-wearing and handwashing to slow down and prevent viral transmission during critical periods that may affect mother-child interactions. METHODS: A longitudinal observational study was conducted with primiparous women recruited using convenience sampling from the postpartum care ward of Afzalipour Teaching Hospital in Kerman from August 1, 2020 to March 30, 2021. The research questionnaires included demographic information, preventive behaviors, breastfeeding intention and practices, postpartum distress, and Edinburgh Postpartum Depression Scale. All the questionnaires were self-reported online in three stages: before discharge from the postpartum ward, the first month after delivery, and the third month after delivery. RESULTS: A Total of 160 primiparous women were included. The results showed significant changes in preventive behaviors and postpartum distress levels during the study. Breastfeeding intention and practices were negatively affected by postpartum distress (P = 0.034), unwanted pregnancies (P = 0.009), and cesarean delivery (P < 0.001). Postpartum distress was directly affected by the presence of depression (P < 0.001). Preventive behaviors at discharge were significantly associated with postpartum distress three months after delivery (P = 0.013). The study also found an association between women's and partner's education, unwanted pregnancy, and cesarean delivery that determined postpartum distress. CONCLUSIONS: Pandemic restrictions did not affect breastfeeding intentions or practices, possibly due to sufficient social and family support during the pandemic. However, robust guidelines are required to increase enable women's access to specializede care to cope with future pandemics, particularly during the first few weeks after childbirth.

Neonatal hypernatremic dehydration in breastfed neonates: a prospective study unmasking the influences of breastfeeding practices and early weight monitoring.

Introduction: Hypernatremic dehydration in neonates is an uncommon but serious reason for re-hospitalization, especially in exclusively breastfed neonates. The aim was to study the incidence, associated maternal and neonatal characteristics and risk factors, and presenting features of neonatal hypernatremic dehydration (NHD). Methods: A prospective study design was employed to enroll full-term newborns admitted with serum sodium concentrations of ≥145 mEq/L from April 2022 to March 2023 at a tertiary care rural hospital. Maternal and neonatal characteristics and breastfeeding practices of these mother-baby pairs were recorded and observed. Healthy control for every mother-baby pair was taken. Ethical clearance and informed consent were obtained from mothers. Result: 34 newborns out of total 672 NICU admissions were admitted due to NHD, with an incidence of 4.7%. Primiparous mothers were 23 (67.6%) in the cases and 10 (29.4%) in the control group (p = 0.0017). Disparity in maternal breastfeeding practices of cases, such as delayed initiation time 2.3 h vs. 1.27 h (p < 0.0001), less frequency of breastfeeding 6.5 times vs. 9.3 times (p < 0.0001), and duration of breastfeeding sessions 23.3 min vs. 32 min (p = 0.0014) respectively in cases and controls were found to be potential contributing factors. 61.7% of mothers had breast issues in the cases and 17.6% in the control group (p = 0.0002) with average LATCH score of 4.29 in cases as compared to 8.08 in controls (p < 0.0001) at time of baby's admission to NICU. The average neonatal age at presentation was six days and average weight loss was 11.4% in cases vs. 2.8% in controls (p < 0.0001). The main presenting features were excessive weight loss 30 (88.2%), lethargy 20 (58.8%), jaundice 18 (52.9%) and fever 14 (41.1%). Conclusion: Neonatal hypernatremic dehydration (NHD) poses a significant clinical challenge, particularly in full-term, exclusively breastfed healthy neonates. We found an incidence of 4.7%. Delayed initiation of breastfeeding, inadequate breastfeeding techniques, and maternal breast-related issues were significant contributors to NHD. Primiparous mothers were found to be at higher risk, emphasizing the need for targeted breastfeeding education and support for primiparous mothers. The study reaffirmed the critical role of frequent and effective duration of breastfeeding and daily weight monitoring for preventing NHD.

Beyond the binary: Characterizing the relationships between sex and neuropeptide receptor binding density measures in the rat brain.

Sex differences exist in numerous parameters of the brain. Yet, sex-related factors are part of a large set of variables that interact to affect many aspects of brain structure and function. This raises questions regarding how to interpret findings of sex differences at the level of single brain measures and the brain as a whole. In the present study, we reanalyzed two datasets consisting of measures of oxytocin, vasopressin V1a, and mu opioid receptor binding densities in multiple brain regions in rats. At the level of single brain measures, we found that sex differences were rarely dimorphic and were largely persistent across estrous stage and parental status but not across age or context. At the level of aggregates of brain measures showing sex differences, we tested whether individual brains are 'mosaics' of female-typical and male-typical measures or are internally consistent, having either only female-typical or only male-typical measures. We found mosaicism for measures showing overlap between females and males. Mosaicism was higher a) with a larger number of measures, b) with smaller effect sizes of the sex difference in these measures, and c) in rats with more diverse life experiences. Together, these results highlight the limitations of the binary framework for interpreting sex effects on the brain and suggest two complementary pathways to studying the contribution of sex to brain function: (1) focusing on measures showing dimorphic and persistent sex differences and (2) exploring the relations between specific brain mosaics and specific endpoints.

Effect of Acupressure on Anxiety and Pain Levels in Primiparous Women During Normal Labor: A Randomized Controlled Trial.

Background: Normal labor is stressful, and the intense pain and anxiety can have an adverse effect on the mother, the fetus, and the delivery procedure. This study aimed to determine how acupressure applied to multiple acupoints during normal labor affected labor pain and anxiety in primiparous women. Method: This study was a double-blinded randomized controlled trial that involved 43 primiparous women aging 20-30 years who were referred for normal labor. Subjects were randomly allocated to one of two groups: acupressure or control. Acupressure was administered to the Large Intestine 4 (LI4), Heart 7 (He-7), and Spleen 6 (SP6) acupoints in the acupressure group, whereas sham acupressure was administered to the control group. The study assessed the mothers' anxiety levels using the Spielberger Inventory questionnaire and measured their pain levels using the visual analog scale before and after the intervention. In addition, pulse rate and blood pressure were also measured. Result: In the acupressure group, both the anxiety score and pain level showed a substantial improvement (p < 0.001), but in the control group, only the anxiety score showed a significant improvement (p < 0.001). After the intervention, the difference in anxiety and pain scores between the two groups is statistically significant (p < 0.001). Furthermore, neither group's blood pressure nor pulse rate showed any significant changes (p < 0.05). Conclusion: According to the study's findings, acupressure targeting LI4, He-7, and SP6 acupoints was effective in relieving anxiety and pain during labor. Compared with the sham acupressure group, the acupressure group showed a greater decrease in both anxiety and pain levels. As such, acupressure may be recommended as an effective, affordable, and accessible technique for managing pain and anxiety during labor. This study has been registered in the database of clinical trials under the identifier Clinicaltrials.gov NCT05411289.

Effect of sustained release bolus oral administration on body condition change, blood parameters, and uterine health in primiparous cows under heat stress.

The transition period is very stressful for primiparous cows due to their first calving experience and will be more challenging if it occurs under heat stress conditions. Heat stress reduces the feed intake of dairy cows. Therefore, it reduces the consumption of minerals and vitamins. Oral administration of boluses through the provision of mineral-vitamin compounds can reduce metabolic abnormalities after calving. The present study aimed to evaluate effect of sustained-release bolus on body condition score (BCS) change, serum metabolites, uterine health, and reproductive status in primiparous cows. Heifers were selected at the beginning of the close-up period (n = 60, BCS = 3.35 ± 0.12). There were 2 experimental treatments at the time of calving: (1) heifers without bolus oral administration (H - Bo, n = 30); (2) heifers with bolus oral administration (H + Bo, n = 30). The results showed that although the rate of BCS loss was lower in the group receiving bolus, the effect of bolus was not significant. The effect of bolus on blood level of glucose, non-esterified fatty acids (NEFA), and beta-hydroxybutyrate (BHBA) was not significant; however, the highest concentration of albumin (P = 0.05) was observed in the H + Bo group on day 42 after calving. The concentration of aspartate transaminase (AST) tended to increase (P = 0.06) on day 14 after calving and entire the study. Total antioxidant capacity (TAC) was affected (P < 0.05) by bolus throughout the period of study, and the highest (P < 0.05) concentration of glutathione peroxidase (GPX) and superoxide dismutase (SOD) was observed in H + Bo group on day 42 after calving. The H + Bo group had the lowest (P < 0.05) vaginal discharge score (VDS). In general, oral administration of the sustained-release bolus in heifers significantly affected the antioxidant factors and uterine health, as well as had positive effects on liver function, body condition, and reproduction status.