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International Urogynecology Journal Mar 2021To evaluate the evidence for pathologies underlying stress urinary incontinence (SUI) in women. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION AND HYPOTHESIS
To evaluate the evidence for pathologies underlying stress urinary incontinence (SUI) in women.
METHODS
For the data sources, a structured search of the peer-reviewed literature (English language; 1960-April 2020) was conducted using predefined key terms in PubMed and Embase. Google Scholar was also searched. Peer-reviewed manuscripts that reported on anatomical, physiological or functional differences between females with signs and/or symptoms consistent with SUI and a concurrently recruited control group of continent females without any substantive urogynecological symptoms. Of 4629 publications screened, 84 met the inclusion criteria and were retained, among which 24 were included in meta-analyses.
RESULTS
Selection bias was moderate to high; < 25% of studies controlled for major confounding variables for SUI (e.g., age, BMI and parity). There was a lack of standardization of methods among studies, and several measurement issues were identified. Results were synthesized qualitatively, and, where possible, random-effects meta-analyses were conducted. Deficits in urethral and bladder neck structure and support, neuromuscular and mechanical function of the striated urethral sphincter (SUS) and levator ani muscles all appear to be associated with SUI. Meta-analyses showed that observed bladder neck dilation and lower functional urethral length, bladder neck support and maximum urethral closure pressures are strong characteristic signs of SUI.
CONCLUSION
The pathology of SUI is multifactorial, with strong evidence pointing to bladder neck and urethral incompetence. While there is also evidence of impaired urethral support and levator ani function, standardized approaches to measurement are needed to generate higher levels of evidence.
Topics: Female; Humans; Parity; Pelvic Floor; Pregnancy; Urethra; Urinary Bladder; Urinary Incontinence, Stress
PubMed: 33416968
DOI: 10.1007/s00192-020-04622-9 -
Journal of Atherosclerosis and... Feb 2023
Topics: Pregnancy; Female; Humans; Parity; Cardiovascular Diseases; Risk Factors
PubMed: 35599001
DOI: 10.5551/jat.ED203 -
Ugeskrift For Laeger Nov 2023Rusty pipe syndrome (RPS) is a benign, self-limiting condition characterized by bloody milk secretion, and is primarily seen among primiparous women. This case report...
Rusty pipe syndrome (RPS) is a benign, self-limiting condition characterized by bloody milk secretion, and is primarily seen among primiparous women. This case report highlights the clinical presentation of a 31-year-old primiparous woman with bloody milk secretion from gestational week 31. This persisted throughout pregnancy until seven days after birth. RPS should be considered in pregnant women with painless bilateral bloody milk secretion during pregnancy and/or the early days post-partum. The milk can safely be provided to the infant, and RPS is not an indication for formula feeding.
Topics: Infant; Female; Pregnancy; Humans; Adult; Animals; Breast Feeding; Lactation; Milk; Postpartum Period; Syndrome; Parity
PubMed: 38018741
DOI: No ID Found -
International Urogynecology Journal Dec 2022The objective was to test the hypotheses that a linear relationship exists between age and levator bowl volume (LBV); and that age, parity, and prolapse are...
INTRODUCTION AND HYPOTHESIS
The objective was to test the hypotheses that a linear relationship exists between age and levator bowl volume (LBV); and that age, parity, and prolapse are independently associated with LBV.
METHODS
We conducted a secondary analysis of data from nulliparous women, parous controls, and prolapse (Pelvic Organ Prolapse Quantification (POP-Q) Ba ≥ 1 cm) cases from each of three age groups: young (≤40), mid-age (50-60), and older (≥70). LBV was measured using MRI at rest and Valsalva as the 3D space contained above the levator ani muscles and below the sacrococcygeal junction-to-inferior pubic point reference plane. Linear regression models were used to examine the effects of age, parity, prolapse, and their interactions (age*parity and age*prolapse) on LBV.
RESULTS
Each group consisted of 9-12 women. LBV increased with age in a nonlinear fashion. For nulliparous women, the median value increased 4.7% per decade from the young to mid-age group and 84% per decade from the mid-age to older group; for parous controls, the corresponding increases were 38% and -0.5%; and for women with prolapse, they were 46% and 11%. Age and prolapse status (both p<0.001) were found to be significant independent predictors of LBV. Interactions between age*prolapse (p=0.003) and age*parity (p=0.045) were also independently associated with LBV.
CONCLUSIONS
Parity and prolapse influence how age affects LBV. In nulliparous women, age had little effect on LBV until after mid-age. For women with prolapse, LBV increased at a much earlier age, with the biggest difference occurring between young and mid-age women.
Topics: Humans; Female; Pregnancy; Parity; Pelvic Floor; Pelvic Organ Prolapse; Magnetic Resonance Imaging; Ultrasonography
PubMed: 35503121
DOI: 10.1007/s00192-022-05203-8 -
Journal of Alzheimer's Disease : JAD 2023Race/ethnicity is associated with differences in reproductive history and cognition individually, yet it remains an understudied factor in the relationship between...
BACKGROUND
Race/ethnicity is associated with differences in reproductive history and cognition individually, yet it remains an understudied factor in the relationship between parity and later-life cognition.
OBJECTIVE
To evaluate if the association between parity and cognition differs between racial/ethnic groups.
METHODS
Participants included 778 older, postmenopausal women from the Health and Nutrition Examination Survey (Latina: n = 178, Non-Latino Black [NLB]: n = 169, Non-Latino White [NLW]: n = 431) who self-reported at least one birth. Cognitive outcomes included working memory, learning memory, and verbal fluency. Covariates included age, education, cardiovascular and other reproductive health factors, adult socioeconomic status (SES) and depressive symptoms. We fit a series of linear models to examine a) whether parity was associated with cognitive functioning, b) if this association varied by race/ethnicity through parity by race/ethnicity interactions, and c) individual parity with cognition associations stratified by race/ethnicity.
RESULTS
In the full sample, parity was significantly negatively associated with Digit Symbol Substitution Test (DSST) performance (b = -0.70, p = 0.024) but not Animal Fluency or word-list learning and memory. Tests of race/ethnicity-by-parity interactions were not statistically significant (ps > 0.05). However, stratified analyses by race/ethnicity showed a differential effect of parity on DSST performance, such that parity was significantly negatively associated with DSST performance (b = -1.66, p = 0.007) among Latinas but not in NLWs (b = -0.16, p = 0.74) or NLBs (b = -0.81, p = 0.191).
CONCLUSION
Among Latina, but not NLB or NLW women, greater parity was associated with worse processing speed/executive functioning later in life. Further research is needed to understand the mechanisms driving racial/ethnic differences.
Topics: Female; Humans; Cognition; Ethnicity; Hispanic or Latino; Parity; Racial Groups; Aged; Postmenopause; Black or African American; White; Cognition Disorders
PubMed: 37393496
DOI: 10.3233/JAD-221210 -
PloS One 2022To examine how (a) parity and (b) mode of birth were associated with later Quality of Life (QOL) in young adult women, with a mean follow-up of 11.0 years.
OBJECTIVE
To examine how (a) parity and (b) mode of birth were associated with later Quality of Life (QOL) in young adult women, with a mean follow-up of 11.0 years.
DESIGN
Prospective cohort study.
SETTING
Australia.
R SAMPLE
A total of 7770 women participating in the 1973-1978 cohort of the Longitudinal Study of Women's Health.
METHODS
Linear regression models were used to estimate (1) prospective associations between parity and mode of birth with eight subscale and two summary scores of the SF36, assessed after a mean follow-up of 11 years., and (2) differences between SF36 scores at follow up for women in different parity and mode of birth categories.
MAIN OUTCOME MEASURE
Quality of Life as measured by the SF36.
RESULTS
Women experiencing no births (parity 0) and one birth (parity 1) had lower scores on all the physical health measures, and on some mental health measures, than women who had 2 births (parity 2) (all p<0.05).
CONCLUSIONS
Parity and mode of birth may have long-term implications for women's physical and mental health. Both childless and women with only one child had poorer physical and mental health than their peers with two children. Women with only caesarean section(s) also had poorer health than women who had vaginal birth/s.
Topics: Cesarean Section; Child; Delivery, Obstetric; Female; Humans; Longitudinal Studies; Parity; Pregnancy; Prospective Studies; Quality of Life; Young Adult
PubMed: 36084030
DOI: 10.1371/journal.pone.0273366 -
Journal of Dairy Science Mar 2022Nonambulatory dairy cattle pose a complex problem due to the challenges associated with prevention, appropriate treatment and management, and arriving at an accurate... (Review)
Review
Nonambulatory dairy cattle pose a complex problem due to the challenges associated with prevention, appropriate treatment and management, and arriving at an accurate prognosis. There is a breadth of literature regarding this topic, of which there is currently no formal synthesis. The objective of this scoping review was to describe and characterize the literature investigating risk factors, sequela, preventions, treatments, and prognostic factors for nonambulatory conditions in dairy cattle, with the intent of qualitatively synthesizing knowledge of the topic and identifying gaps in the literature. A literature search was conducted in 6 databases and 2 conference proceeding archives, which returned 7,568 unique articles. Initial screening of abstracts resulted in 1,544 articles reviewed at the full-text stage, of which 379 were included for data extraction. Over 75% of the included literature was published after 1980, and the most common countries in which these studies took place were the United States (n = 72), Canada (18), Sweden (17), and Germany (17). Common eligibility criteria used for inclusion were geographic region (97) and parity (92). Of the 379 studies included in this review, 144 were randomized controlled trials and 235 were observational studies. The majority of the controlled trials assessed prevention of nonambulatory conditions (116), most commonly through supplementation of vitamin D (27) and calcium (25) or the provision of anionic salts (22). Of the 28 studies focusing on treatment of nonambulatory conditions, 26 focused on calcium administration. Becoming nonambulatory was evaluated as an outcome in 165 of the observational studies. Frequently measured risk factors for becoming nonambulatory included hematological variables, such as blood calcium (73), phosphorus (53) and magnesium (42), and other factors such as parity (35) and breed (22). Recovery from a nonambulatory condition was the outcome in 31 of the observational studies, with commonly measured prognostic indicators being calcium (9), phosphorus (9), and duration of recumbency (7). Nonambulatory disorders were measured as risk factors in 53 of the observational studies, with the most commonly assessed outcomes including disorders of the transition period (11), and death or euthanasia (11). The most common terms used to describe nonambulatory conditions were "milk fever" (199) and "parturient paresis" (147). These terms were only further defined with explicit symptomatic criteria in 193 of the 379 studies in this review. Recumbency was the most commonly used of these criteria (144), followed by inability to rise (55). Potential gaps in the literature concerning nonambulatory dairy cattle that were identified in the present review included investigation of prognostic indicators for recovery from nonambulatory conditions that are applicable on farm, treatment alternatives to calcium administration, and guidance regarding the appropriate usage of terms meant to categorize nonambulatory dairy cattle.
Topics: Animals; Cattle; Cattle Diseases; Female; Hypocalcemia; Magnesium; Parity; Parturient Paresis; Pregnancy
PubMed: 34955243
DOI: 10.3168/jds.2021-21046 -
American Journal of Public Health Sep 2017
Topics: Delivery, Obstetric; Female; Humans; Longevity; Maternal Age; Parity; Pregnancy; United States; Women's Health
PubMed: 28787196
DOI: 10.2105/AJPH.2017.303971 -
BMC Women's Health Mar 2022Pregnancy has been considered a risk factor for the development of osteoporosis. Despite much research in this field, the relationship between parity and bone mineral...
BACKGROUND
Pregnancy has been considered a risk factor for the development of osteoporosis. Despite much research in this field, the relationship between parity and bone mineral density (BMD) is still controversial. Therefore, we conducted this study to investigate whether there was an association between parity and BMD of the femoral neck and lumbar spine in postmenopausal women.
METHODS
Cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES). Three linear regression models, Model 1 (unadjusted), Model 2 (adjusted for age and body mass index (BMI)), and Model 3 (adjusted for all covariates), were established to evaluate the relationship between parity and BMD. In addition, the p value trend of BMD in the different parity groups was mutually verified with the results of multiple regression. Multiple logistic regression models were used to assess the relationship between parity and osteoporosis.
RESULTS
In total, 924 postmenopausal women aged 45-65 years were eligible for this study. After adjustment for potential confounders, women with ≥ 6 parities had significantly lower lumbar spine BMD than women with 1-2 parities (β = - 0.072, 95% CI: - 0.125, - 0.018, P = 0.009). However, there was no correlation between parity and femoral neck BMD in any of the three regression models. Furthermore, ≥ 6 parities were associated with a significantly higher prevalence of lumbar spine osteoporosis compared with 1-2 parities (OR = 3.876, 95% CI: 1.637, 9.175, P = 0.002).
CONCLUSIONS
After adjustment for BMD-related risk factors, ≥ 6 parities were associated with decreased lumbar spine BMD but not femoral neck BMD in postmenopausal women. This suggests that postmenopausal women with high parity are at increased risk of lumbar osteoporotic fractures and should pay more attention to their bone health.
Topics: Absorptiometry, Photon; Bone Density; Cross-Sectional Studies; Female; Humans; Lumbar Vertebrae; Nutrition Surveys; Osteoporosis; Osteoporosis, Postmenopausal; Parity; Postmenopause; Pregnancy
PubMed: 35321721
DOI: 10.1186/s12905-022-01662-9 -
Scientific Reports Jul 2022Gestation increases the biomechanical loading of lower extremities. Gestational loading may influence anthropometrics of articular surfaces in similar means as bone...
Gestation increases the biomechanical loading of lower extremities. Gestational loading may influence anthropometrics of articular surfaces in similar means as bone diaphyseal properties. This study aimed to investigate whether gravidity (i.e. number of pregnancies) and parity (i.e. number of deliveries) is associated with knee breadth among middle-aged women. The study sample comprised 815 women from the Northern Finland Birth Cohort 1966. The median parity count of our sample was 2 and the median gravidity count 3. At the age of 46, questionnaires were used to enquire gravidity and parity, and posteroanterior knee radiographs were used to obtain two knee breadth parameters (tibial plateau mediolateral breadth (TPML) and femoral condylar mediolateral breadth (FCML)) as representatives of articular size. The associations of gravidity and parity with knee breadth were analyzed using general linear models with adjustments for height, weight, leisure-time physical activity, smoking, and education years. Individuals with osteoarthritic changes were excluded from our sample. The mean TPML in our sample was 70.3 mm and the mean FCML 71.6 mm respectively. In the fully adjusted models, gravidity and parity showed positive associations with knee breadth. Each pregnancy was associated with 0.11-0.14% larger knee breath (p < 0.05), and each delivery accounted for an increase of 0.20% in knee breadth (p < 0.01). Between-group comparisons showed that multiparous women had 0.68-1.01% larger knee breath than nulli- and primiparous women (p < 0.05). Pregnancies and deliveries seem to increase the mediolateral breadth of the knee. This increase is potentially associated with increased biomechanical loadings during gestation.
Topics: Cohort Studies; Female; Gravidity; Humans; Knee; Knee Joint; Middle Aged; Parity; Pregnancy
PubMed: 35858984
DOI: 10.1038/s41598-022-16231-1