Neuraxial analgesia interfered with the circadian rhythm of labor: a propensity score matched cohort study

Objectives To investigate whether neuraxial analgesia and other medical interventions have effects on the circadian rhythm of labor. Methods It was a retrospective propensity score matched cohort study. Parturients were recruited, who delivered term singletons in cephalic position, from seven hospitals in Harvard University Partners Healthcare Systems, 2016–2018. The parturients were divided into two groups, neuraxial analgesia delivery and spontaneous vaginal delivery, the stratification was performed according to labor induction, oxytocin, operative delivery. The parturients in each group were divided into 12 periods in every 2 h based on the birth time of babies. Cosine function fitting was used to verify whether the birth time had the characteristic of circadian rhythm. Results In spontaneous vaginal deliveries, the peak of birth time was at 2:00–4:00, and the nadir was at 14:00–16:00, this showed a circadian rhythm presented by a cosine curve fitting with the formula (y = 0.0847 + 0.01711 × cos(− 0.2138 × x + 0.4471). The labor rhythm of NAD (Neuraxial Analgesia Delivery) group changed completely, inconsistent with the cosine curve fitting of the circadian rhythm. The intervention of induction and oxytocin blurred the circadian rhythm of SVD (Spontaneous Vaginal Delivery) group and increased the amplitude of the fluctuation in NAD (Neuraxial Analgesia Delivery) group. The intervention of operative delivery had changed the distribution curve completely both in the SVD (Spontaneous Vaginal Delivery) group and the NAD (Neuraxial Analgesia Delivery) group. Conclusions Neuraxial analgesia did affect on circadian rhythm of labor, changed the cosine rhythm of labor with spontaneous vaginal delivery, and this trend was aggravated by the use of induction, oxytocin and operative delivery.

Fraccaro syndrome (49, XXXXY): A case study, review of clinical features and a systematic review in Iranian population

We described the clinical, biochemical, hormonal and developmental status of a patient with 49,XXXXY syndrome with routine Fraccaro syndrome features accompanied with sexual masturbation behavior. This study were compiled and summarized the clinical features and also maternal age at birth time in all yet 49,XXXXY reported in the Iranian population.

Mothers of children with major congenital anomalies have increased health care utilization over a 20-year post-birth time horizon

Objective This population-based, matched cohort study aimed to evaluate utilization of health care services by mothers of children with major congenital anomalies (MCAs), compared to mothers of children without MCAs over a 20-year post-birth time horizon in Denmark. Methods Our analytic sample included mothers who gave birth to an infant with a MCA (n = 23,927) and a cohort of mothers matched to them by maternal age, parity and infant’s year of birth (n = 239,076). Primary outcomes were period prevalence and mothers’ quantity of health care utilization (primary, inpatient, outpatient, surgical, and psychiatric services) stratified by their child’s age (i.e., ages 0–6 = before school, ages 7–13 = pre-school + primary education, and ages 14–18 = secondary education or higher). The secondary outcome measure was length of hospital stays. Outcome measures were adjusted for maternal age at delivery, parity, marital status, income quartile, level of education in the year prior to the index birth, previous spontaneous abortions, maternal pregnancy complications, maternal diabetes, hypertension, alcohol-related diseases, and maternal smoking. Results In both cohorts the majority of mothers were between 26 and 35 years of age, married, and employed, and 47% were primiparous. Mothers of infants with anomalies had greater utilization of outpatient, inpatient, surgical, and psychiatric services, compared with mothers in the matched cohort. Inpatient service utilization was greater in the exposed cohort up to 13 years after a child’s birth, with the highest risk in the first six years after birth [adjusted risk ratio, 1.13; 95% confidence interval (CI), 1.12–1.14], with a decrease over time. Regarding the quantity of health care utilization, the greatest difference between the two groups was in inpatient service utilization, with a 39% increased rate in the exposed cohort during the first six years after birth (adjusted rate ratio, 1.39; 95% CI, 1.37–1.42). During the first 6 years after birth, mothers of children with anomalies stayed a median of 6 days (interquartile range [IQR], 3–13) in hospital overall, while the comparison cohort stayed a median of 4 days (IQR, 2–7) in hospital overall. Rates of utilization of outpatient clinics (adjusted rate ratio, 1.36; 95% CI, 1.29–1.42), as well as inpatient (adjusted rate ratio, 1.77; 95% CI, 1.68–1.87), and surgical services (adjusted rate ratio, 1.33; 95% CI, 1.26–1.41) was higher in mothers of children with multiple-organ MCAs during 0 to 6 years after birth. Among mothers at the lowest income levels, utilization of psychiatric clinic services increased to 59% and when their child was 7 to 13 years of age (adjusted rate ratio, 1.59; 95% CI, 1.24–2.03). Conclusion Mothers of infants with a major congenital anomaly had greater health care utilization across services. Health care utilization decreased over time or remained stable for outpatient, inpatient, and surgical care services, whereas psychiatric utilization increased for up to 13 years after an affected child’s birth. Healthcare utilization was significantly elevated among mothers of children with multiple MCAs and among those at the lowest income levels.

Trends and inequalities in breastfeeding continuation from 1 to 6 weeks: findings from six population-based British cohorts, 1985–2010

Background Understanding inequalities in breastfeeding practices may help to explain the UK’s persistently low breastfeeding rates. A recent study using the quinquennial UK Infant Feeding Surveys (IFS) found that sociodemographic inequalities in breastfeeding initiation persisted between 1985 and 2010. The present study investigates the sociodemographic inequalities in breastfeeding continuation at 6 weeks after birth among mothers who initiated and maintained breastfeeding at 1 week in 1985–2010. Methods Data were drawn from the 1985 to 2010 IFS and restricted to mothers who were breastfeeding at 1 week after birth. Time trends in the proportion of mothers in each sociodemographic group were examined. Logistic regression was used to estimate associations between breastfeeding at 6 weeks and sociodemographic factors, adjusting for confounders. Heterogeneity test was used to assess changes in these associations over time. Results Sociodemographic inequalities in breastfeeding continuation at 6 weeks persisted over the 25-year period. In most survey years, mothers were most likely to breastfeed at 6 weeks if they were 30 or older versus under 25 (OR 1.49–1.99 across survey years, I2 = 0%, heterogeneity P = 0.45); completed full-time education over age 18 compared to 18 or younger (OR 1.56-2.51, I2 = 58.7%, P = 0.03); or of Black, Asian, Mixed, or other ethnicity compared to White (OR 1.45–2.48, I2 = 44.8%, P = 0.16). Conclusions Among mothers breastfeeding at 1 week, those who were younger, White or had fewer years of full-time education were at greatest risk of discontinuing before 6 weeks. This risk persisted over time and was independent of their high risk of not initiating breastfeeding.

Father’s Involvement during the Pregnancy and Child Birth Time in Nepal

This study was conducted in two districts: Lamjung and Chitawan. All the respondents were 25 years and above fathers. The study collected data from face to face in–depth interviews. The findings show that almost respondents (fathers) care their pregnancy wives. Furthermore, 25-40 age group respondents care their pregnant wives more sensitively: they are aware of providing rest, not allowing carrying loads, supplying nutritious food, providing love and affection, go together for pregnancy checkup and regular help to solve their wives’ problems at pregnancy time.

A narrative review about challenges in periand postnatal management of gastroschisis

Gastroschisis is a malformation of the closure of the anterior abdominal wall which has had a growing incidence in recent years. It is a borderline pathology between several specialties such as: obstetrics, neonatology, pediatric surgery, family medicine and requires many resources. In general, the chance of survival of newborns with gastroschisis is high. However, complex cases with complications are more likely to have an unfavorable prognosis. The therapeutic plan should start from the intra-embryonic period, from the time of the ultrasound diagnosis and it should extend over a long period of time, which can vary depending on the case, and on the surgical options. When it comes to the management of the cases, there is no valid protocol for all the cases, and there is a great variability starting with the choice of birth time, birth pathway, the option of reintegrating the intestinal loops and closing the abdominal defect. Because of this, the cases of gastroschisis represent a challenge for modern medicine, when also taking into account the fact that the etiopathogenesis of this malformation is not clearly established and that there is a large variety of therapeutic options.

A REVIEW OF CORRELATION BETWEEN GRAHA-NAKSHATRA AND NAKSHATRA VRIKSHAS WITH ASTROLOGICAL AND AYURVEDIC APPROACH

There is a huge relation between humans and plants. In Hinduism, vriksha have been considered like God. With the hope of achieving good health and accomplishment of works, the legislation for their worship and protection is very ancient. Ayurveda and astrology are proven to be an Indian heritage. They both are established with a scientific base. Nowadays they have got worldwide acceptance. The aim of both the sciences is to maintain the physical and mental health of human beings. Nakshatras have a very close relationship with nature, due to changes in nakshatras transformation occur in plants and all living beings. it has been seen that the graha and nakshatras related to our birth time have a wide impact on humans it is described in many old scriptures and Ayurveda. Indian astrology has stated 27 nakshatras with their vriksha. The nakshatra at which a person is born is considered to be his or her birth nakshatra. Each nakshatra has a relation with a vriksha, it is called nakshatra vriksha this is described in rajnighantu they are also known as aradhya vrikshas (worshipped plant). It is also described in many old scriptures and Ayurveda.1 Keywords: graha, nakshatra, nakshatra vriksha, aradhya vriksha.

Impact of Offspring Sex and Dam’s Pre-partum Vaccination on Colostrum Composition and Blood Hormones in Egyptian Buffaloes

An The aim of the present research was to determine the effect of both the gender of the new-born calf and the pre-partum vaccination status of the dam (ScourGuard-4K) on the chemical composition and some biological parameters of the colostrum. Blood serum was collected from four groups of pregnant dams (four animals in each group) during the dry period (vaccinated buffalo dams pregnant with a male fetus, vaccinated buffalo dams pregnant with a female fetus, unvaccinated buffalo dams pregnant with a male fetus, and unvaccinated buffalo dams pregnant with a female fetus), in the pregnancy period, at the giving-birth period and after 24 hours of postpartum. The levels of insulin-like growth factor hormone (IGF-1) and immunoglobuline G (IgG) were calculated in the maternal blood serum at the assigned periods. Colostrum samples were collected at the birth time and 6, 12, 24, 48, and 72 hours after birth for measuring the chemical composition of the colostrum, as well as levels of IgG and IGF-1. Results of the current study showed that colostrum of dams that gave birth to male fetus had a richer content of IgG and IGF-1 levels and a higher percentage of total solids, solids-not-fat, total protein, fat, and lactose. Additionally, vaccination improved the same colostrum components except for IGF-1, which was not positively influenced by the vaccination. Generally, colostrum components were the highest at the birth time, then it decreased gradually up to 72 hours after the birth except that for the percentage of fat and lactose which showed gradual increases up to 72 hours to reach the normal composition of milk.