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Biomedical subjects

F Parazzini

Publications and source records attributed to F Parazzini.

394 records · Page 22Linked to original sources

[Exposure to low-frequency electromagnetic fields and pregnancy outcome: a review of the literature with particular attention to exposure to video terminals].

Exposure to extremely low frequency electromagnetic field (EMF) is very common and concern about its harmful effects has been raised. Video display terminals (VDT) in the office are among the most important sources of exposure. Animal studies have shown adverse effects on reproduction, but the role of EMF in human reproduction is not clear. Twelve papers considering the effects of VDT and other EMF exposure on pregnancy outcome are reviewed. Concerning VDT exposure, the pooled OR for spontaneous abortion was 1.0 (95% Confidence Interval, CI, 0.9-1.0). There was no significative trend in risk with exposure intensity. No significative risk emerged for low birth weight nor for congenital malformations. Regarding other sources of EMF (electric blankets, heated waterbeds, ceiling cable electric heat and power lines), some studies have suggested that spontaneous abortion, growth retardation and congenital defects are more frequent during the coldest month of the year (when the exposure to these EMF would have been higher). However, data on the issue are scanty.

Animals↗

[Standards of birth weight in Italy].

The Italian standards of birth weight have been computed using information routinely collected by the Italian Central Institute of Statistics on about 1,200,000 births in the period 1984-1985. Individual records include data on birth weight and main fetal and maternal characteristics and delivery modalities. The crude and smoothed 5th, 10th, 50th, 90th and 95th centiles of weight at birth as function of gestational age according to sex, type of birth, maternal age and parity are presented. Centiles of weight at birth were higher (about 5%) in males than in females in all gestational ages: for example the 50th centile of weight at 40 weeks gestation was 3479 g in males and 3332 g in females. Between the 28th and the 32nd week the 50th centile of birth weight for multiple births grew at a rate similar to that of singletons; but beyond 32 weeks the weight growth in multiple birth was markedly lower than in singleton ones, the median multiple birth weight reaching the 10th centile of singleton at 38 weeks. The values of centiles increased with parity in both sexes and all gestational ages. The difference was however limited: for example with reference to the 50th centile the value for births in women reporting three or more births was about 5% higher than in those reporting no previous birth. Likewise, centiles of weight were higher in older women, but the difference tended to disappear after 36 weeks gestation. This analysis shows from a large national data-set standards of weight at birth from a Southern European population, providing to obstetrics and perinatologists curves of fetal growth more directly representative of the population under their care.

Adolescent↗

[Voluntary interruption of pregnancy in Italy, 1979-1989: analysis of the available data].

This paper presents crude rates (per 1000 women aged 15-49 years) and ratios (per 1000 livebirths) of induced abortion in Italy, North-Central and South Italy and within subgroups of women according to general and social characteristics. Incidence of induced abortion has diminished of 30% between 1982 and 1989, although this decrement is less marked in the South. Women between 30 and 34 years reported more induced abortions than those of other ages, but they present--together with women aged from 20 to 29--a more important decrease of their rates (from 25 induced abortions/1000 women in 1982 to 19/1000 in 1987). On the other hand, there is no decrease in rates and there is some increase in ratios in women aged 40-49 years. Married women have a greater incidence, but also a greater reduction of rates and ratios than not married women. A high level of education is related to high rates and ratios in early 80's, but these values have shown an important decrease in the period 1982-1987. Frequency of induced abortion is higher in women with two children than in other groups of women. In the frame of general decrement of induced abortion incidence, women with higher values in early 80's have shown greater reductions in the last ten years.

Abortion, Induced↗

[Risks and benefits of the contraceptive pill. A review of the results of an Italian study].

The association between oral contraceptives (o.c.) and disease risk was reviewed on the basis of data from a network of a case-control studies conducted in northern Italy since the early 1980's on about 150 cases below age 55 with acute myocardial infarction, 150 with gallstone disease, 350 with uterine fibromyoma, 170 with endometrial cancer, 700 with benign or malignant ovarian tumours, 2000 with breast cancer, 360 with intraepithelial and 370 with invasive cervical cancer, 20 with liver cancer plus over 2000 control women admitted to hospital for acute, non hormone-related non neoplastic diseases. The relative risk (RR) of myocardial infarction was 2.1 (95% confidence interval from 0.7 to 7.1) among current o.c. users, but only 4% of women were current users. There was no association between gallstone disease, uterine fibromyoma and o.c. use. Significant protections were observed with reference to endometrial cancer and benign, borderline and malignant ovarian tumours, while the RR was above unity (RR = 1.9) for invasive cervical cancer, but not for intraepithelial cervical neoplasia. A significantly increased risk was observed for primary liver cancer, which is however extremely rare in young women. With reference to breast cancer, there was no consistent duration-risk relationship, and the RR was 0.8 for use for 5 or more years. Thus, these data provide reassuring information on the relationship between o.c. use and the risk of several important diseases in a Southern European population.

Contraceptives, Oral↗

[Determinants of the frequency of cesarean section in Italy, 1980-1983].

The frequency and determinants of cesarean section rates in Italy were analyzed using data collected routinely by the Italian Central Institute of Statistics on more than 2,400,000 deliveries in 1980-83. The rate of cesarean section in Italy rose from 11.2/100 deliveries in 1980 to 14.5 in 1983. This increase was comparable with other European countries, although the rate of abdominal deliveries was still about 30-40% lower than in the United States and Canada. In the southern (and less rich) areas, the rate of cesarean section was about 40% lower than in the North or Centre of Italy. The rate of cesarean birth rose constantly with maternal age; being in comparison with teen-agers, about three times higher in women aged 45 years or more. Compared with women with primary or intermediate degree, those with university education reported about 40% higher rate of cesarean section, but this differences was markedly reduced after taking into account maternal age and birth weight. In southern areas of the country the frequency of cesarean birth was about 40% higher in public hospital than in private ones (11.5 and 8.1/100 deliveries, respectively), while in northern and central areas the frequency of cesarean birth was higher in private hospital than public ones (18.5 vs 14.7/100 deliveries in the North, and 19.6 vs 14.6/100 deliveries in the Centre). There were relationships between cesarean rates and birth weight or gestational weeks. The lowest values were observed in very low birth weight (less than or equal to 999 gr) as in babies weighing 3000-3999 gr and in deliveries occurred between the 25th and 27th gestational weeks and in term deliveries. About 55% of deliveries with breech presentation were delivered by cesarean section.

Adolescent↗

[Determinants of perinatal and infant mortality in Italy 1980-1983].

Determinants of stillbirth, perinatal and infant mortality in Italy have been analyzed using information collected routinely by the Italian Central Institute of Statistics on more than 2,400,000 births and 33,000 infant deaths in the period 1980-1983. Individual records include data on maternal (for example age, education, obstetric history) and fetal (sex, birth weight, gestational week at birth) characteristics. The Italian stillbirth, perinatal and infant (1st-365th day of life) mortality rates were respectively 7.7/1000 births, 16.4/1000 births and 13.5/1000 livebirths for the considered period. Perinatal and infant mortality was impressive in very low birth weight. About 90% of livebirths weighing less than 1000g died within the first year of life, but this percentage decreased to about 45% in babies weighing 1000-1499g. As a whole, low birth weight explained more than 70% of deaths. Further, stillbirth, perinatal and infant mortality rates were higher in male babies, in older women and in higher birth rank. These findings persist, although less markedly, after adjustment for weight. Mortality rates were about 60-70% higher in less educated women. Stillbirth, perinatal and infant mortality rates were 20 to 30% higher in Southern Italy, as compared to the North of the country. This finding was not markedly changed after adjustment for birth weight and maternal age and education, suggesting that socio-economic factors are per se important determinants of perinatal and infant mortality in Italy, and explain in terms of population attributable risk, about 15% of stillbirths or deaths within the first year of life.

Birth Weight↗

[Assessment of the use of Pap test in a sample of pregnant women].

Four hundred and ninety-nine women were interviewed who gave birth in the "L. Mangiagali" Obstetrics-Gynaecological Clinic between March and April 1989. 22% of these women had never had a Pap-test, 37% reported having had 1-2 cervical smears and 41% 3 or more. In the group of patients that contacted a private gynaecologist during pregnancy, the percentage of women who had never had a Pap-test was 18% versus 30% in the group of subjects followed in the public health service. Although pluriparas reported a greater number of Pap-test than primiparas, this difference was not statistically significant. Youth is significantly related to the probability of never having had a cervical smear. Social and economic factors were also clearly important. In particular, women with a low educational level represented the group with the highest risk for the lack of cervical screening. The role of the gynaecologist and preventive programmes aimed at the higher risk levels play an important role in terms of heightening awareness.

Adult↗

[The smoking habit in pregnancy: results of a survey conducted in Milan].

The prevalence of smoking in pregnancy has been analyzed in a surveillance of women delivering between February and March 1989 in a large maternity clinic in Milan, Northern Italy. Out of the 411 interviewed women, 133 (32%) were current smokers before and 71 quit smoking during pregnancy. The probability to quit smoking decreased with increasing age and was lower in less educated women; these findings were however not statistically significant. Considering persistent smokers only, the mean number of cigarettes per day decreased from 13 before pregnancy to 8 during gestation; this finding was generally consistent in various subgroups of age and education. These reduction, however, are probably overestimated, since they are based on women's report only. Thus, these findings indicate that there is still ample scope for intervention on smoking in pregnancy, particularly in older and less educated women.

Adult↗

[Frequency of multiple pregnancies in various Italian regions: 1955-1983].

The trend in frequency of multiple birth in Italy has been analyzed on the basis of the number of single and multiple births, according to age and regions, published annually by the Central Institute of Statistics. The rates and ratios of twin and triple or more pregnancy were computed for region, children sex and calendar period. Specific and standardized rates by maternal age are presented here too. Between 1955 and 1983 the frequency of multiple births declined from 12.6/1000 to 9.6/1000 deliveries. The downward trend was constant till the late 70's, when multiple pregnancy rates flattened out, being constant till the early 80's. This was largely attributable to decreasing trend in dizygotic multiple pregnancies, the monozygotic rates were generally constant over the considered period. Rates of triple births decreased slightly till the early 70's and increased in relative and absolute terms from late 70's on, thus if in the quinquennium 1955-1959 only 1 out of 99 multiple births was a triplet, this ratio increased to 1 out of 70 in 1980-1983. There was no noticeable variation in the North/South multiple birth frequency ratio, which was constantly about 0.7. Similarly the national trends were generally reproduced in various regions, the regional differences were largely attributable to differences in dizygotic multiple pregnancy rates.

Adult↗

[Epidemiology of spontaneous abortion: a review of the literature].

Spontaneous abortion is the commonest complication of pregnancy. Its reported incidence appears to be constant in developed countries but the frequency of subclinical fetal loss is largely unknown. There is a well known relationship between fetal loss and advancing maternal age. Trisomic fetuses occur more commonly in older women and most are aborted but old women are also at greater risk of aborting a chromosomally normal fetus. Recent epidemiological data have demonstrated a significant association between maternal cigarette smoking and spontaneous abortion. A role of gravidity, early age at menarche, alcohol and methylxanthine consumption has been recently claimed, but epidemiological evidence is scanty and largely controversial. The present paper reviews the epidemiological data on spontaneous abortion.

Abortion, Spontaneous↗

[Study of the reliability of a parenteral questionnaire used in a pediatric follow-up of 18-month-old children].

We are conducting a validation study of questionnaire to the parents according to the Griffiths Mental Developmental Scale, used in pediatric follow-up of obstetric studies among the Italian population. The questionnaire concerns the child's gross and fine motor and language development, swallowing, respiratory, hearing and vision problems, and hospital admissions within the first 18 months of life. The purpose of this study is to examine the degree of agreement between parental and professional assessment of normal and high-risk infants development at 18 months of life.

Child Development↗

[Birth weight of infants born between the 23rd and 42nd gestational week in Italy].

The Italian distribution of birth weight has been computed using information routinely collected by the Italian Central Institute of Statistics on about 1,150,000 births in the period 1984-1985. Individual records include data on birth weight for single/multiple births for 28th-42nd gestational weeks and for delivery modalities for 23rd-27th gestational weeks, according to sex. This analysis shows, from a large national data-set, distribution of weight at birth from a Southern European population, providing to obstetrics and perinatologists curves of fetal growth more directly representative of the population under their care.

Birth Weight↗