Comparisons of the Prevalence, Severity, and Risk Factors of Dysmenorrhea between Japanese Female Athletes and Non-Athletes in Universities

This study aimed to investigate the difference in the prevalence, severity, and risk factors of dysmenorrhea between Japanese female athletes and non-athletes in universities. The participants were 18 to 30 years old with no history of a previous pregnancy and/or childbirth. After application of the exclusion criteria, the cohort comprised 605 athletes and 295 non-athletes. An anonymous questionnaire, which included self-reported information on age, height, weight, age at menarche, menstrual cycle days, menstrual duration, dysmenorrhea severity, sleeping hours, dietary habits, exercise habits, training hours, and competition level was administered. Compared with athletes, non-athletes had a higher prevalence of dysmenorrhea (85.6% in athletes, 90.5% in athletes, p < 0.05); non-athletes also demonstrated increased severity (none/mild 27.8%, moderate 19.3%, and severe 52.9% in athletes; none/mild 21.2%, moderate 17.2%, and severe 61.6% in non-athletes; p < 0.05). Factors related to severe dysmenorrhea in athletes included long training hours, early menarche, and prolonged menstrual periods. In non-athletes, short menstrual cycle days and extended menstrual periods were related to severe dysmenorrhea. The prevalence and severity of dysmenorrhea were higher among non-athletes than among athletes; different factors were related to severe dysmenorrhea in these two groups. Thus, different strategies are necessary to manage dysmenorrhea for athletes and non-athletes in universities.

Protection against Congenital CMV Infection Conferred by MVA-Vectored Subunit Vaccines Extends to a Second Pregnancy after Maternal Challenge with a Heterologous, Novel Strain Variant

Maternal reinfection of immune women with novel human cytomegalovirus (HCMV) strains acquired during pregnancy can result in symptomatic congenital CMV (cCMV) infection. Novel animal model strategies are needed to explore vaccine-mediated protections against maternal reinfection. To investigate this in the guinea pig cytomegalovirus (GPCMV) model, a strictly in vivo-passaged workpool of a novel strain, the CIDMTR strain (dose, 1 × 107 pfu) was used to infect dams that had been challenged in a previous pregnancy with the 22122 strain, following either sham-immunization (vector only) or vaccination with MVA-vectored gB, gH/gL, or pentameric complex (PC) vaccines. Maternal DNAemia cleared by day 21 in the glycoprotein-vaccinated dams, but not in the sham-immunized dams. Mean pup birth weights were 72.85 ± 10.2, 80.0 ± 6.9, 81.4 ± 14.1, and 89.38 ± 8.4 g in sham-immunized, gB, gH/gL, and PC groups, respectively (p < 0.01 for control v. PC). Pup mortality in the sham-immunized group was 6/12 (50%), but reduced to 3/35 (8.6%) in combined vaccine groups (p = 0.0048). Vertical CIDMTR transmission occurred in 6/12 pups (50%) in the sham-vaccinated group, compared to 2/34 pups (6%) in the vaccine groups (p = 0.002). We conclude that guinea pigs immunized with vectored vaccines expressing 22122 strain-specific glycoproteins are protected after a reinfection with a novel, heterologous clinical isolate (CIDMTR) in a second pregnancy.

The iodine knowledge of pregnant women in an endemic goiter area: a cross-sectional study

Purpose This study aims to determine the level of knowledge about iodine nutrition during pregnancy among pregnant women living in the area of Turkey where goiter is endemic. Design/methodology/approach A total of 150 pregnant women aged between 19 and 45 years, registered at the Gynaecology and Obstetrics Clinic in Trabzon were recruited. The data was collected through a voluntary face-to-face survey with pregnant women. The questionnaire comprising questions determining the sociodemographic characteristics of the participants, data concerning any previous pregnancy, iodized salt consumption habits and knowledge about iodine. Findings Although 68% of the women knew that iodine deficiency can cause serious consequences during pregnancy, the remainder did not. The three main dietary sources of iodine in Turkey are fish, cow’s milk and table salt; of the women, 68%, 20% and 77.3%, respectively, correctly identified these as good sources. The more educated of the pregnant women had significantly higher knowledge scores (p < 0.001). However, age, trimester, parity and previous receipt of information about iodine and iodine knowledge scores made no significant differences. Research limitations/implications This study may not be generalizable for all pregnant women. Originality/value To the best of the authors’ knowledge, this study is the first pilot study to evaluate the level of knowledge regarding iodine among pregnant women in Turkey.

The effects of precisely meeting estimated daily energy and lysine requirements for gestating sows over three consecutive pregnancies on sow reproductive and lactation performance

The objective of the current study was to determine effects of precisely meeting estimated daily energy and Lys requirements for gestating sows over three consecutive pregnancies on sow reproductive and lactation performance. A total of 105 sows (initial reproductive cycle 1.4±0.5) were randomly assigned to a precision (PF; n=50) or control (CON; n=55) feeding program between d 2 and 9 of gestation and housed in group-pens equipped with electronic sow feeders capable of blending two diets. The PF sows received unique daily blends of two isocaloric diets [2518 kcal/kg NE; 0.80 and 0.20% standardized ileal digestible (SID) Lys, respectively] while CON sows received a static blend throughout gestation to achieve 0.56% SID Lys. After weaning, sows were re-bred and entered the same feeding program as in the previous pregnancy for two subsequent pregnancy cycles (PF: n=36; CON: n=37; average reproductive cycle: 2.4±0.5; PF: n=25; CON: n=24; average reproductive cycle: 3.5±0.5). Sows on the PF program received 97, 105, and 118 % (average over three pregnancy cycles) of dietary energy and 67, 79, and 106 % of SID Lys intakes compared to CON between d 5 and 37, 38 and 72, and 73 and 108 of gestation, respectively. Estimated N (26.1 %) retention did not differ between gestation feeding programs in any pregnancy, but excess N excretion was less (1617 vs. 1750 ± 54 g/sow; P &lt; 0.01) for PF versus CON sows. Regardless of pregnancy cycle, sows that received the PF program had greater ADG between d 38 and 72 (614 vs. 518 ± 63 g/d; P &lt; 0.05) and between d 73 and 108 (719 vs. 618 ± 94 g/d; P = 0.063) of gestation, and greater loin depth gain between d 63 and 110 of gestation (0.7 vs. -1.1 ± 1.6 mm; P &lt; 0.05), but BW (235.1 kg) and backfat (17.8 mm) and loin (70.5 mm) depths on d 110 of gestation did not differ. The number of piglets born alive, stillborn, and mummified, and litter birth weight (16.5 kg) did not differ in any pregnancy cycle, nor did piglet ADG during lactation (250 g/d) and piglet BW (6.7 kg) at weaning. Sows that received the PF program during gestation had lower ADFI during lactation (5.7 vs. 6.2 ± 0.2 kg; P &lt; 0.01). Therefore, using feeding programs that precisely match estimated daily energy and Lys requirements for gestating sows provides the opportunity to reduce N losses to the environment and reduce lactation feed usage, without negatively affecting sow reproductive and lactation performance.

Ovarian Reserve Assessed by the Anti-Mullerian Hormone and Reproductive Health Parameters in Women With Crohn´s Disease, a Case-Control Study

According to several studies, women with Crohn's disease (CD) had reduced fertility, which is mostly due to voluntary decisions and reduced ovarian reserve. In our study, we aimed to compare reproductive health parameters (RHP), previous pregnancy complications and outcomes, and ovarian reserve (OR) assessed by the anti-Mullerian hormone (AMH) in CD patients with healthy controls. In CD patients, we also compared OR according to disease phenotypes. Consecutive pre-menopausal women with CD from two IBD centers were included. The control group consisted of age and BMI-matched healthy controls. We used a questionnaire that included RHP, CD phenotype, and CD activity. Serum AMH was assessed by the Elecsys AMH plus essay. We enrolled 50 patients and 56 controls with a median age of 31 years. All CD patients were in clinical remission. We observed no difference in RHP or AMH (median 2.6 vs. 2.1 ug/l, p = 0.98), or the proportion of low OR (AMH<1,77, 38 vs. 41.1 %, p=0.84). The slope of age-related decrease did not differ between the groups. The subgroup of CD patients after surgery and those older than 30 years with CD for >5years had a steeper decrease in AMH (slope -0.12 vs. -0.29, p = 0.04 and -0.31 vs. -0.2, p = 0.029). In a multivariate analysis, age was the single independent predictor of low OR (OR=1.25). In women with Crohn’s disease, once the disease activity is under control, the reproductive health and ovarian reserve do not substantially differ from healthy controls.

Disrupted PGR-B and ESR1 signaling underlies defective decidualization linked to severe preeclampsia

Background:Decidualization of the uterine mucosa drives the maternal adaptation to invasion by the placenta. Appropriate depth of placental invasion is needed to support a healthy pregnancy; shallow invasion is associated with the development of severe preeclampsia (sPE). Maternal contribution to sPE through failed decidualization is an important determinant of placental phenotype. However, the molecular mechanism underlying the in vivo defect linking decidualization to sPE is unknown.Methods:Global RNA sequencing was applied to obtain the transcriptomic profile of endometrial biopsies collected from nonpregnant women who suffer sPE in a previous pregnancy and women who did not develop this condition. Samples were randomized in two cohorts, the training and the test set, to identify the fingerprinting encoding defective decidualization in sPE and its subsequent validation. Gene Ontology enrichment and an interaction network were performed to deepen in pathways impaired by genetic dysregulation in sPE. Finally, the main modulators of decidualization, estrogen receptor 1 (ESR1) and progesterone receptor B (PGR-B), were assessed at the level of gene expression and protein abundance.Results:Here, we discover the footprint encoding this decidualization defect comprising 120 genes—using global gene expression profiling in decidua from women who developed sPE in a previous pregnancy. This signature allowed us to effectively segregate samples into sPE and control groups. ESR1 and PGR were highly interconnected with the dynamic network of the defective decidualization fingerprint. ESR1 and PGR-B gene expression and protein abundance were remarkably disrupted in sPE.Conclusions:Thus, the transcriptomic signature of impaired decidualization implicates dysregulated hormonal signaling in the decidual endometria in women who developed sPE. These findings reveal a potential footprint that could be leveraged for a preconception or early prenatal screening of sPE risk, thus improving prevention and early treatments.Funding:This work has been supported by the grant PI19/01659 (MCIU/AEI/FEDER, UE) from the Spanish Carlos III Institute awarded to TGG. NCM was supported by the PhD program FDGENT/2019/008 from the Spanish Generalitat Valenciana. IMB was supported by the PhD program PRE2019-090770 and funding was provided by the grant RTI2018-094946-B-100 (MCIU/AEI/FEDER, UE) from the Spanish Ministry of Science and Innovation with CS as principal investigator. This research was funded partially by Igenomix S.L.

An analysis of preferences and practices related to the mode of delivery in Agra district of Uttar Pradesh

Background: Preferences and actual practices in regard to delivery of pregnant women have wide variations. This study is an attempt to explore some of the socio-demographic factors responsible for preferences and practices in regard to mode of delivery among institutional deliveries in Agra district.Methods: This community based descriptive observational study was conducted among 300 eligible women of Agra district who were selected through multistage random sampling. Both bivariate and multivariate analysis was done and appropriate statistical tests were used.Results: The study found that out of 300 subjects; 272 had institutional deliveries among which 265 (97.43%) had a preference for vaginal delivery (VD) while only 7 (2.57%) had a preference for caesarean section (CS) but in actuality, 223 (81.99%) were delivered through vaginal mode while 49 (18.01%) had CS. On multiple logistic regression analysis, mode of delivery in previous pregnancy was found to have a significant association with the preference of a woman in regard to her mode of delivery with odds ratio of 9.88 (95% CI 1.46-66.80) and p=0.019.Conclusions: Preferences in regard to mode of delivery of a woman was only associated with her mode of delivery in previous pregnancy but her actual practice was also significantly associated with her place of delivery in addition to her mode of delivery in previous pregnancy.

236 Factors Influencing Clearance of Pregnancy-associated Glycoproteins in Postpartum Beef Cattle

Blood pregnancy tests can determine pregnancy status in cattle; however, pregnancy-associated glycoproteins (PAGs) have a long half-life (80 to 100 d). If tested too soon after calving, false positive readings can occur due to elevated concentrations from the previous pregnancy. This study’s objective was to determine factors that impact clearance of PAGs in postpartum beef females. Blood samples were collected from postpartum Angus and Angus-cross females (primiparous n = 46 and multiparous n = 58); once a week for up to 14 weeks after calving (range of first to last sample 1–7 to 98–105 days postpartum; dpp). Serum was tested in duplicate using the IDEXX Alertys Pregnancy Test. Data were analyzed as a repeated measure using the MIXED procedure of SAS (9.4) with parity, calf sex (sex), days postpartum, and all interactions in the model. Data were analyzed using the REG procedure in SAS. There was a significant effect of dpp (P &lt; 0.01) on PAG concentrations; however, PAG concentrations were not influenced by parity (P = 0.24), sex (P = 0.49), parity by dpp (P = 0.12), parity by sex (P = 0.65), sex by dpp (P = 0.37), or parity by sex by dpp (P = 0.99). Concentrations of PAGs rapidly decreased from d 0 to 50 postpartum and then continued to gradually decrease to d 100. Days postpartum accounted for 67.53% of the variation in PAG concentrations. Prior to 50 dpp, PAG concentrations were sufficiently elevated which resulted in false positive readings (S – N ≥ 0.3). In summary, concentrations of PAGs remained elevated after calving, but the clearance of PAGs were not impacted by parity or sex of the calf. Clearance of PAGs were significantly influenced by days postpartum. Additionally, using a blood pregnancy test prior to d 50 postpartum would increase the likelihood of false positive readings due to residual PAG concentrations from the previous pregnancy.

Development and internal validation of a model predicting severe maternal morbidity using pre-conception and early pregnancy variables: a population-based study in Ontario, Canada

Background Improvement in the prediction and prevention of severe maternal morbidity (SMM) - a range of life-threatening conditions during pregnancy, at delivery or within 42 days postpartum - is a public health priority. Reduction of SMM at a population level would be facilitated by early identification and prediction. We sought to develop and internally validate a model to predict maternal end-organ injury or death using variables routinely collected during pre-pregnancy and the early pregnancy period. Methods We performed a population-based cohort study using linked administrative health data in Ontario, Canada, from April 1, 2006 to March 31, 2014. We included women aged 18–60 years with a livebirth or stillbirth, of which one birth was randomly selected per woman. We constructed a clinical prediction model for the primary composite outcome of any maternal end-organ injury or death, arising between 20 weeks’ gestation and 42 days after the birth hospital discharge date. Our model included variables collected from 12 months before estimated conception until 19 weeks’ gestation. We developed a separate model for parous women to allow for the inclusion of factors from previous pregnancy(ies). Results Of 634,290 women, 1969 experienced the primary composite outcome (3.1 per 1000). Predictive factors in the main model included maternal world region of origin, chronic medical conditions, parity, and obstetrical/perinatal issues – with moderate model discrimination (C-statistic 0.68, 95% CI 0.66–0.69). Among 333,435 parous women, the C-statistic was 0.71 (0.69–0.73) in the model using variables from the current (index) pregnancy as well as pre-pregnancy predictors and variables from any previous pregnancy. Conclusions A combination of factors ascertained early in pregnancy through a basic medical history help to identify women at risk for severe morbidity, who may benefit from targeted preventive and surveillance strategies including appropriate specialty-based antenatal care pathways. Further refinement and external validation of this model are warranted and can support evidence-based improvements in clinical practice.