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European Journal of Obstetrics,... Aug 2021We assessed clinical interpretation of the word parity amongst obstetricians and midwives in Wales and performed a literature review to identify a standardised... (Review)
Review
OBJECTIVES
We assessed clinical interpretation of the word parity amongst obstetricians and midwives in Wales and performed a literature review to identify a standardised definition.
STUDY DESIGN
A survey was conducted by electronic questionnaire to obstetricians across Wales and midwives across North Wales. The questionnaire was distributed to obstetricians using the Wales Information System. Midwives were surveyed using a health board wide distribution list. This was followed by a literature review using dictionaries, standard texts, professional bodies and websites. References were obtained for the UK, USA, India, Malaysia and West Indies.
RESULTS
There were 143 responses from 63 doctors and 80 midwives. 5% of doctors and 49 % of midwives did not include stillbirths after 24 completed weeks in their definition of parity. 84 % of all surveyed described having a previous twin delivery as Para 2. 23 references were obtained for a definition of parity. Parity was variability defined as the number of conceptions, pregnancies, births and babies. Only 12 sources offered a definition in reference to multiple pregnancy. Of these, 8 sources defined multiple births as a single parous event.
CONCLUSIONS
There are variations in definitions for the term parity from referenced sources and variation in understanding amongst staff surveyed. We recommend UK professional bodies take into consideration the findings of this study and provide a standard consensus definition of parity.
Topics: Female; Humans; India; Malaysia; Midwifery; Parity; Pregnancy; Surveys and Questionnaires
PubMed: 34129962
DOI: 10.1016/j.ejogrb.2021.05.042 -
Child: Care, Health and Development Jan 2023Maternal parity, which is usually measured as the number of children born to a mother, has a substantial impact on the social and environmental factors around children...
BACKGROUND
Maternal parity, which is usually measured as the number of children born to a mother, has a substantial impact on the social and environmental factors around children and their development. This paper estimates the Early Childhood Development Index (ECDI) of 3- and 4-year-old children in Bangladesh and examines the relationship between maternal parity and early childhood development.
METHODS
The study analysed nationally representative data from the Bangladesh Multiple Indicator Cluster Survey 2019. The dataset had 9453 children aged from 36 to 59 months. The ECDI was computed following the UNICEF's approach involving psychometric computation of four domains of development: physical, literacy-numeracy, learning and social-emotional. Since the dataset has a hierarchical structure, we used multilevel logistic regression.
RESULTS
A quarter (25%) of the children were not on track in their early childhood development. Seventy-one percent were not developmentally on track in the literacy-numeracy domain, 27% were not in the social-emotional and smaller percentages were not in learning (9%) and physical (1%) domains. There was a significant negative association between maternal parity and ECDI (adjusted odds ratio [AOR] 0.95; 95% CI: 0.91-0.99). Attendance at early childhood education programmes was significantly associated with early childhood development (AOR 1.73; 95% CI: 1.47-2.03). Also, female children, those who were not stunted, located in rural areas, received parental stimulation activities, lived in relatively wealthy households or had mothers who had received secondary or further education were more likely than others to be on track of early childhood development.
CONCLUSIONS
Early childhood development is negatively correlated with maternal parity. The literacy-numeracy domain constitutes the major developmental delay. Programmes for parental awareness should be widely expanded.
Topics: Pregnancy; Child, Preschool; Humans; Female; Parity; Child Development; Literacy; Mothers; Family Characteristics
PubMed: 35384014
DOI: 10.1111/cch.13011 -
Epidemiology and Psychiatric Sciences Oct 2020To investigate the association between parity and the risk of incident dementia in women.
AIMS
To investigate the association between parity and the risk of incident dementia in women.
METHODS
We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)).
RESULTS
Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02-1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1-4 parities (HR = 1.30, 95% CI = 1.02-1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02-1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00-2.55), but the risk of AD was not significantly associated with parity.
CONCLUSIONS
Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.
Topics: Aged; Aged, 80 and over; Alzheimer Disease; China; Cohort Studies; Dementia; Europe; Female; Geriatric Psychiatry; Humans; Incidence; Independent Living; Middle Aged; Parity; Pregnancy; Proportional Hazards Models; Republic of Korea; Risk Factors; Socioeconomic Factors
PubMed: 33077022
DOI: 10.1017/S2045796020000876 -
Maturitas Jan 2022To evaluate the association between parity and breastfeeding and anti-Müllerian hormone levels (AMH) and change in AMH levels over time. Furthermore, we examined... (Observational Study)
Observational Study
OBJECTIVE
To evaluate the association between parity and breastfeeding and anti-Müllerian hormone levels (AMH) and change in AMH levels over time. Furthermore, we examined whether AMH levels mediate the relation of parity and breastfeeding with age at menopause.
STUDY DESIGN
Observational, prospective cohort study.
MAIN OUTCOME MEASURES
AMH levels were assessed in a subset of premenopausal participants in the Nurses' Health Study II, including 1619 women who provided a blood sample in 1996-1999 and an additional 800 women who provided a second premenopausal sample in 2010-2012.
RESULTS
In multivariable linear regression models adjusted for parity, body mass index, smoking, and other factors, mean log AMH levels in 1996-1999 were 39% higher in women reporting ≥25 months of total breastfeeding vs. <1 month (P for trend = 0.009). Parity was not associated with AMH levels after adjustment for breastfeeding. Neither parity nor breastfeeding was associated with decline in AMH levels over 11 to 15 years. Breastfeeding duration was positively associated with age at menopause (P for trend = 0.01), with evidence that the association was mediated via AMH.
CONCLUSIONS
Our results suggest that breastfeeding is associated with higher AMH levels and later onset of menopause, and support the hypothesis that observed relations of parity with AMH levels and menopause timing may be largely attributable to breastfeeding.
Topics: Anti-Mullerian Hormone; Breast Feeding; Female; Humans; Menopause; Parity; Pregnancy; Prospective Studies
PubMed: 34876244
DOI: 10.1016/j.maturitas.2021.09.006 -
International Journal of Environmental... Sep 2020Pregnancy-related anxiety is contextualised by pregnancy and is a health concern for the mother and child. Perceived parental self-efficacy is associated with this...
Pregnancy-related anxiety is contextualised by pregnancy and is a health concern for the mother and child. Perceived parental self-efficacy is associated with this anxiety and age and parity are identified as influential factors. This research, therefore, predicted that negative perceptions of parental self-efficacy would predict greater pregnancy-related anxiety, moderated by parity and age. Participants ( = 771) were recruited online and assessed for perceived parental self-efficacy, pregnancy-related anxiety, and demographics. Moderation models showed that the psychosocial and sociodemographic factors combined predicted up to 49% of the variance. Parental self-efficacy predicted anxiety in the areas of body image, worry about themselves, baby concerns, pregnancy acceptance, attitudes towards medical staff and childbirth, and avoidance. Parity predicted pregnancy-related anxiety both overall and in childbirth concerns, worry about self, baby concerns and attitudes towards childbirth. Age predicted baby concerns. There was a significant moderation effect for pregnancy acceptance indicating that primiparous women with low perceptions of parental self-efficacy are less accepting of their pregnancy. Results suggest that parity and parental self-efficacy may be risk factors for first-time mothers for pregnancy-related anxiety.
Topics: Anxiety; Female; Humans; Parity; Parturition; Pregnancy; Pregnant Women; Self Efficacy; Surveys and Questionnaires
PubMed: 32942604
DOI: 10.3390/ijerph17186709 -
Journal of Dairy Science Mar 2021The objective of this study was to estimate the cost of metritis in dairy herds. Data from 11,733 dairy cows from 16 different farms located in 4 different regions of...
The objective of this study was to estimate the cost of metritis in dairy herds. Data from 11,733 dairy cows from 16 different farms located in 4 different regions of the United States were compiled for up to 305 d in milk, and 11,581 cows (2,907 with and 8,674 without metritis) were used for this study. Metritis was defined as fetid, watery, red-brownish vaginal discharge that occurs ≤21 d in milk. Continuous outcomes such as 305-d milk production, milk sales ($/cow), cow sales ($/cow), metritis treatment costs ($/cow), replacement costs ($/cow), reproduction costs ($/cow), feeding costs ($/cow), and gross profit per cow ($/cow) were analyzed using mixed effect models using the MIXED procedure of SAS (SAS Institute Inc., Cary, NC). Gross profit was also compared using the Kruskal-Wallis test. Dichotomous outcomes such as pregnant and culling by 305 d in milk were analyzed using the GLIMMIX procedure of SAS. Time to pregnancy and culling were analyzed using the PHREG procedure of SAS. Models included the fixed effects of metritis, parity, and the interaction between metritis and parity, and farm as the random effect. Variables were considered significant when P ≤ 0.05. Metritis cost was calculated by subtracting the gross profit of cows with metritis from the gross profit of cows without metritis. A stochastic analysis was performed with 10,000 iterations using the observed results from each group. Milk yield and proportion of cows pregnant were lesser for cows with metritis than for cows without metritis, whereas the proportion of cows leaving the herd was greater for cows with metritis than for cows without metritis. Milk sales, feeding costs, residual cow value, and gross profit were lesser for cows with metritis than for cows without metritis. Cow sales and replacement costs were greater for cows with metritis than for cows without metritis. The mean cost of metritis from the study herds was $511 and the median was $398. The stochastic analysis showed that the mean cost of a case of metritis was $513, with 95% of the scenarios ranging from $240 to $884, and that milk price, treatment cost, replacement cost, and feed cost explained 59%, 19%, 12%, and 7%, respectively, of the total variation in cash flow differences. In conclusion, metritis caused large economic losses to dairy herds by decreasing milk production, reproduction, and survival in the herd.
Topics: Animals; Cattle; Cattle Diseases; Dairying; Female; Lactation; Milk; Parity; Pregnancy; Reproduction
PubMed: 33455790
DOI: 10.3168/jds.2020-19125 -
PloS One 2023Female reproductive history, especially high parity, affects general health and may impact negatively on oral health. While parity has been positively linked to tooth...
BACKGROUND
Female reproductive history, especially high parity, affects general health and may impact negatively on oral health. While parity has been positively linked to tooth loss, the specific association between parity and caries has not been adequately investigated.
AIM
To determine the association between parity and caries in a population of higher parity women. Influences of likely confounders (age, socio-economic status, reproductive parameters, oral health practices and sugar consumption between meals) were considered.
METHODS
This was a cross-sectional study involving 635 Hausa women of varying parity aged 13-80 years. Socio-demographic status, oral health practices and sugar consumption were obtained using a structured interviewer-administered questionnaire. All decayed, missing and filled teeth due to caries (excluding third molars) were noted, and tooth loss etiology was queried. Associations with caries were evaluated through correlation, ANOVA, post hoc analyses and Student's t tests. Effect sizes were considered for magnitude of differences. Multiple regression (binomial model) was used to investigate predictors of caries.
RESULTS
Hausa women had a high prevalence of caries (41.4%) despite low sugar consumption; nonetheless the overall mean DMFT score was very low (1.23 ± 2.42). Older, higher parity women experienced more caries, as did those with longer reproductive spans. Additionally, poor oral hygiene, use of fluoride toothpaste and frequency of sugar consumption were significantly associated with caries.
CONCLUSION
Higher parity (>6 children) was associated with higher DMFT scores. These results suggest that a form of maternal depletion, expressed as heightened caries susceptibility and subsequent tooth loss, occurs with higher parity.
Topics: Child; Pregnancy; Humans; Female; Parity; Cross-Sectional Studies; Dental Caries; Tooth Loss; Dietary Sugars
PubMed: 36862679
DOI: 10.1371/journal.pone.0281653 -
Journal of Animal Science Apr 2022Energy demands during lactation greatly influence sow body condition and piglet performance. We hypothesized that primiparous sows or sows with reduced body condition...
Energy demands during lactation greatly influence sow body condition and piglet performance. We hypothesized that primiparous sows or sows with reduced body condition would produce piglets with reduced growth and delayed sexual maturation. Eight weekly farrowing seasons were used to evaluate sow body condition (post-farrowing, PF and weaning, WN) and piglet growth from 157 dams. Body condition was measured at PF and WN using sow calipers (last rib and hip) and 10th rib ultrasound. Sows were categorized as thin, moderate, or fat by caliper (PF or WN). Individual pig weights were recorded on approximately 1, 10, WN, 45, 100, and 145 d of age. At 100 and 145 d of age, 10th-rib backfat and loin eye area were measured on 567 pigs and first estrus was monitored in 176 gilts reserved for breeding selection beginning at approximately 170 d of age. Sows had similar (P > 0.10) PF last rib caliper measurements but at WN, first parity sows had the smallest caliper measurements compared to other parities (P < 0.05). Parities 1, 2, and 3 sows had similar (P > 0.10) loin eye area at PF; however, at WN first parity sows had the smallest loin eye area (P < 0.05; 38.2 ± 0.63 cm2). Parity 1 sows had the greatest (P < 0.05) reduction of backfat and loin eye area over the lactation period (-2.9 ± 0.31 mm and -2.6 ± 0.49 cm2, respectively). At 1 d of age and WN, piglets from first parity sows weighed the least (P < 0.05) but were the heaviest (P < 0.05) at 100 and 145 d of age. Pigs from first parity litters had larger (P < 0.05) loin eye area at 100 and 145 d of age and greater backfat (P < 0.05) at 145 d of age. Fat sows at WN (last rib or hip) had the lightest (P < 0.05) piglets at 10 d of age and WN. However, at 45 d of age, piglets from fat sows (last rib or hip) were heavier (P < 0.05) than piglets from moderate and thin sows. Tenth rib backfat at 100 and 145 d of age tended (P < 0.10) to be less in pigs reared by thin sows (PF and WN hip). Tenth rib loin eye area was similar among pigs reared by fat, moderate, or thin sows. Gilts developed in litters from fourth parity sows had (P < 0.05) delayed age at puberty in contrast to gilts from first or third parity sows (200.9 ± 4.96 d vs. 189.0 ± 2.29 d and 187.5 ± 2.84 d, respectively). Although progeny body weights were typically less from first parity dams through 45 d of age, these progeny were similar or heavier at 100 and 145 d of age in contrast to progeny from other parities. Furthermore, gilt progeny from first parity dams did not have delayed pubertal attainment.
Topics: Animals; Female; Lactation; Parity; Pregnancy; Sexual Maturation; Sus scrofa; Swine; Weaning
PubMed: 35363309
DOI: 10.1093/jas/skac031 -
Journal of Dairy Science Dec 2021Fourier transform infrared spectroscopy (FTIR) allows for the determination of milk acetone (mACE) and β-hydroxybutyrate (mBHB) concentrations, providing a potential...
Fourier transform infrared spectroscopy (FTIR) allows for the determination of milk acetone (mACE) and β-hydroxybutyrate (mBHB) concentrations, providing a potential herd monitoring tool for hyperketolactia, defined as elevated milk ketone bodies. The study aim was to characterize mACE and mBHB concentration dynamics during early lactation in Polish Holstein-Friesian cows. Milk samples (n = 3,867,390) were collected within 6 to 60 days in milk (DIM) over a 4-yr period (April 1, 2013 to March 31, 2017) from approximately 21,300 dairy herds (average 38.7 cows/herd). Fixed effects of parity, DIM, and their interaction on mACE and mBHB concentrations were determined using a mixed model with a herd-year-season fixed effect and random cow effect. Published hyperketolactic mACE (≥0.15 mmol/L) and mBHB (≥0.10 mmol/L) threshold concentrations were used to classify study milk samples into ketolactia groups of normal (mACE <0.15 mmol/L and mBHB <0.10 mmol/L) and hyperketolactic (HYKL; either mACE ≥0.15 mmol/L or mBHB ≥0.10 mmol/L). Additionally, HYKL samples were categorized into subpopulations as having elevated mBHB and mACE (HYKL, mACE ≥0.15 mmol/L and mBHB ≥0.10 mmol/L), only elevated mBHB (HYKL; mACE <0.15 mmol/L and mBHB ≥0.10 mmol/L), or only elevated mACE (HYKL; mACE ≥0.15 mmol/L and mBHB <0.10 mmol/L). Effects of parity, DIM, ketolactia group or subpopulation, and their interactions on mACE and mBHB concentrations were also determined using the mixed model that included ketolactia group or subpopulation as an independent variable. Across all data, mACE and mBHB concentrations were influenced by effects of parity, DIM, and their interaction as well as parity, DIM, ketolactia group or subpopulation, and their interactions. For all samples, mACE and mBHB concentrations decreased with increasing DIM, with mACE concentration declining more rapidly compared with mBHB. In the data set, 68% and 32% of all samples were defined as normal or HYKL, respectively. Among HYKL samples, mACE was elevated soon after calving and declined over time. In contrast, mBHB started lower after calving and increased reaching peak concentrations around 30 DIM, and then decreased. Within HYKL samples, 50.8, 41.3, and 7.9% were categorized as HYKL, HYKL, and HYKL respectively. Between 6 and 21 DIM, 11.3% of HYKL were classified as HYKL. Primiparous cows had greater (14.8%) HYKL samples in this time period. In conclusion, this study has characterized mACE and mBHB concentrations during early lactation and determined effects of parity, DIM, and their interaction. Using published criteria interpreting mACE and mBHB concentrations, it was intriguing to identify a unique population of samples having elevated mACE without mBHB in early lactation, especially in primiparous cows. Further research is needed to determine if this sample population represents an unhealthy metabolic status that adversely affects cow health and performance.
Topics: 3-Hydroxybutyric Acid; Animals; Cattle; Cattle Diseases; Female; Lactation; Milk; Parity; Pregnancy
PubMed: 34538496
DOI: 10.3168/jds.2020-19734 -
Journal of Public Health (Oxford,... Mar 2023High-risk fertility behaviours such as too early or advanced age at delivery, shorter birth interval, birth order and a higher number of live births to a woman often...
BACKGROUND
High-risk fertility behaviours such as too early or advanced age at delivery, shorter birth interval, birth order and a higher number of live births to a woman often lead to adverse maternal and child health outcomes. We assessed high-risk fertility behaviours and their associated factors among women in sub-Saharan Africa (SSA).
METHODS
Data on 200 716 women pooled from the demographic and health surveys of 27 countries conducted between 2010 and 2020 in SSA were analysed. High-risk fertility behaviour from four indicators, mother aged <18 years at the time of delivery; mother aged >34 years at the time of delivery; mother of a child born after a short birth interval (<24 months) and mother of high parity (>3 children), was derived. Multi-level multi-variable logistic regression analyses were carried out and the results were presented as adjusted odds ratios at 95% confidence interval.
RESULTS
Women who were in polygamous marriages had higher odds of single and multiple high-risk fertility behaviour compared with their counterparts who were in monogamous marriages. Women with middle or high maternal decision-making power had higher odds of single and multiple high-risk fertility behaviours compared with those with low decision-making power. Single and multiple high-risk fertility behaviours were lower among women with access to family planning, those with at least primary education and those whose partners had at least primary education compared with their counterparts who had no access to family planning, those with no formal education and those whose partners had no formal education.
CONCLUSION
Family structure, women's decision-making power, access to family planning, women's level of education and partners' level of education were identified as predictors of high-risk fertility behaviours in SSA. These findings are crucial in addressing maternal health and fertility challenges. Policy makers, maternal health and fertility stakeholders in countries with high prevalence of high parity and short birth intervals should organize programs that will help to reduce the prevalence of these high-risk factors, taking into consideration the factors that predispose women to high-risk fertility behaviours.
Topics: Pregnancy; Child; Female; Humans; Fertility; Family Planning Services; Parity; Marriage; Africa South of the Sahara
PubMed: 34850201
DOI: 10.1093/pubmed/fdab381