Parity Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):402-410
DOI 10.1590/SO100-720320150005418
To investigate the influence of the use of oral hormonal contraceptive agents (OCA) on the biochemical indices related to metabolic zinc utilization and distribution, and to bone turnover in young adult women.
Cross-sectional study. Blood and urine samples from non-users (-OCA; control; n=69) and users of hormonal contraceptives for at least 3 months (+OCA; n=62) were collected under controlled conditions. Indices of zinc homeostasis and of bone turnover were analyzed in serum or plasma (total, albumin-bound and α2-macroglobulin-bound zinc, albumin and total and bone alkaline phosphatase activity), in erythrocytes (zinc and metallothionein) and in urine (zinc, calcium and hydroxyproline). The habitual zinc and calcium intakes were evaluated by a food frequency questionnaire.
Dietary zinc intake was similar in both groups and on average above recommended values, whereas calcium intake was similarly sub-adequate in +OCA and -OCA. Compared to controls, +OCA had lower concentrations of total and α2-macroglobulin-bound zinc (11 and 28.5%, respectively, p<0.001), serum albumin (13%, p<0.01), total and bone-specific alkaline phosphatase activity (13 and 18%, respectively, p<0.05), erythrocyte metallothionein (13%, p<0.01), and, urinary zinc (34%, p<0.05).
OCA use decreases serum zinc, alters zinc distribution in major serum fractions with possible effects on tissue uptake, enhances zinc retention in the body and decreases bone turnover. Prolonged OCA use may lead to lower peak bone mass and/or to impaired bone mass maintenance in young women, particularly in those with marginal calcium intake. The observed OCA effects were more evident in women younger than 25 years and in nulliparous women, deserving special attention in future studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):402-410
DOI 10.1590/SO100-720320150005418
To investigate the influence of the use of oral hormonal contraceptive agents (OCA) on the biochemical indices related to metabolic zinc utilization and distribution, and to bone turnover in young adult women.
Cross-sectional study. Blood and urine samples from non-users (-OCA; control; n=69) and users of hormonal contraceptives for at least 3 months (+OCA; n=62) were collected under controlled conditions. Indices of zinc homeostasis and of bone turnover were analyzed in serum or plasma (total, albumin-bound and α2-macroglobulin-bound zinc, albumin and total and bone alkaline phosphatase activity), in erythrocytes (zinc and metallothionein) and in urine (zinc, calcium and hydroxyproline). The habitual zinc and calcium intakes were evaluated by a food frequency questionnaire.
Dietary zinc intake was similar in both groups and on average above recommended values, whereas calcium intake was similarly sub-adequate in +OCA and -OCA. Compared to controls, +OCA had lower concentrations of total and α2-macroglobulin-bound zinc (11 and 28.5%, respectively, p<0.001), serum albumin (13%, p<0.01), total and bone-specific alkaline phosphatase activity (13 and 18%, respectively, p<0.05), erythrocyte metallothionein (13%, p<0.01), and, urinary zinc (34%, p<0.05).
OCA use decreases serum zinc, alters zinc distribution in major serum fractions with possible effects on tissue uptake, enhances zinc retention in the body and decreases bone turnover. Prolonged OCA use may lead to lower peak bone mass and/or to impaired bone mass maintenance in young women, particularly in those with marginal calcium intake. The observed OCA effects were more evident in women younger than 25 years and in nulliparous women, deserving special attention in future studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):117-122
DOI 10.1590/S0100-72032013000300005
PURPOSE: To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. METHODS: A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. RESULTS: The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm², respectively, versus 12.4 cm² in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). CONCLUSION: Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):117-122
DOI 10.1590/S0100-72032013000300005
PURPOSE: To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. METHODS: A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. RESULTS: The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm², respectively, versus 12.4 cm² in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). CONCLUSION: Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):486-493
DOI 10.1590/S0100-72032008001000002
PURPOSE: to investigate factors accountable for macrosomia incidence in a study with mothers and progeny attended at a Basic Unity of Health in Rio de Janeiro, Brazil. METHODS: a prospective study, with 195 pairs of mothers and progeny, in which the dependent variable was macrosomia (weight at delivery >4,000 g - independent of the gestational age or of other demographic variables), and socioeconomic, previous pregnancies/gestation course, biochemical, behavioral and anthropometric, the independent variables. Statistical analysis has been done by multiple logistic regression. Relative risk (RR) values have been estimated, based on the simple form: RR=OR/ (1 - I0) + (I0 versus OR), in which I0 is the macrosomia incidence in non-exposed people. RESULTS: Macrosomia incidence was 6.7%, the highest value being found in the progeny of women >30 years old (12.8%), white (10.4%), with two or more children (16.7%), with male newborns (9.6%), with height >1,6 m (12.5%), with overweight or obesity as a nutritional pre-gestational state (13.6%), and with excessive gestational gain of weight (12.7%). The final model has shown that having two or more children (RR=3.7; CI95%=1.1-9.9), and having a male newborn (RR=7.5; CI95%=1.0-37.6) were the variables linked to the macrosomia occurrence. CONCLUSIONS: macrosomia incidence was higher than the one observed in Brazil as a whole, but inferior to the one reported in studies from developed countries. Having two or more children and a newborn male were the factors accountable for the occurrence of macrosomia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):486-493
DOI 10.1590/S0100-72032008001000002
PURPOSE: to investigate factors accountable for macrosomia incidence in a study with mothers and progeny attended at a Basic Unity of Health in Rio de Janeiro, Brazil. METHODS: a prospective study, with 195 pairs of mothers and progeny, in which the dependent variable was macrosomia (weight at delivery >4,000 g - independent of the gestational age or of other demographic variables), and socioeconomic, previous pregnancies/gestation course, biochemical, behavioral and anthropometric, the independent variables. Statistical analysis has been done by multiple logistic regression. Relative risk (RR) values have been estimated, based on the simple form: RR=OR/ (1 - I0) + (I0 versus OR), in which I0 is the macrosomia incidence in non-exposed people. RESULTS: Macrosomia incidence was 6.7%, the highest value being found in the progeny of women >30 years old (12.8%), white (10.4%), with two or more children (16.7%), with male newborns (9.6%), with height >1,6 m (12.5%), with overweight or obesity as a nutritional pre-gestational state (13.6%), and with excessive gestational gain of weight (12.7%). The final model has shown that having two or more children (RR=3.7; CI95%=1.1-9.9), and having a male newborn (RR=7.5; CI95%=1.0-37.6) were the variables linked to the macrosomia occurrence. CONCLUSIONS: macrosomia incidence was higher than the one observed in Brazil as a whole, but inferior to the one reported in studies from developed countries. Having two or more children and a newborn male were the factors accountable for the occurrence of macrosomia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):278-284
DOI 10.1590/S0100-72032006000500003
PURPOSE: to analyze race, parity and presence of the progesterone receptor polymorphism, named PROGINS, as factors related to uterine leiomyoma occurrence in Brazilian women. METHODS: we carried out a case-control study, composed of 122 patients with the diagnosis of uterine fibroid and 125 women without the disease. After recording the clinical data, we collected biological material for DNA extraction, polymerase chain reaction and agarose gel electrophoresis in order to identify the presence of PROGINS polymorphism. Statistical analysis was performed using the non-parametric Mann-Whitney test or the chi2 test, depending on the studied variable. The risk for the occurrence of the disease was calculated by the logistic regression model, providing the odds ratio (OR). The adopted significance level was 5% (p<0.05) and the confidence interval was 95% (95% CI). RESULTS: we observed a higher prevalence of "non-white"women - mulatto and black - (50 vs 22.4%) and nulliparas (23.8 vs 11.2%) in the cases, while the progesterone receptor genotype was more often PROGINS positive - heterozygous or mutant homozygous - among the controls (21.6 vs 10.7%). The OR indicated an elevated risk for leiomyoma related to the "non-white"race (OR=3.46; 95% CI: 2.0-6.0) and the nulliparity (OR=3.30; 95% CI: 1.9-5.6), with reduction in the presence of PROGINS-positive genotypes (OR=0.43; 95% CI: 0.2-0.9). CONCLUSIONS: the "non-white"race and nulliparity were considered risk factors for the occurrence of uterine fibroid in the studied population, while PROGINS polymorphism showed to be a protective factor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):278-284
DOI 10.1590/S0100-72032006000500003
PURPOSE: to analyze race, parity and presence of the progesterone receptor polymorphism, named PROGINS, as factors related to uterine leiomyoma occurrence in Brazilian women. METHODS: we carried out a case-control study, composed of 122 patients with the diagnosis of uterine fibroid and 125 women without the disease. After recording the clinical data, we collected biological material for DNA extraction, polymerase chain reaction and agarose gel electrophoresis in order to identify the presence of PROGINS polymorphism. Statistical analysis was performed using the non-parametric Mann-Whitney test or the chi2 test, depending on the studied variable. The risk for the occurrence of the disease was calculated by the logistic regression model, providing the odds ratio (OR). The adopted significance level was 5% (p<0.05) and the confidence interval was 95% (95% CI). RESULTS: we observed a higher prevalence of "non-white"women - mulatto and black - (50 vs 22.4%) and nulliparas (23.8 vs 11.2%) in the cases, while the progesterone receptor genotype was more often PROGINS positive - heterozygous or mutant homozygous - among the controls (21.6 vs 10.7%). The OR indicated an elevated risk for leiomyoma related to the "non-white"race (OR=3.46; 95% CI: 2.0-6.0) and the nulliparity (OR=3.30; 95% CI: 1.9-5.6), with reduction in the presence of PROGINS-positive genotypes (OR=0.43; 95% CI: 0.2-0.9). CONCLUSIONS: the "non-white"race and nulliparity were considered risk factors for the occurrence of uterine fibroid in the studied population, while PROGINS polymorphism showed to be a protective factor.
