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Biomedical subjects

J Kline

Publications and source records attributed to J Kline.

At least 109 records · Page 6Linked to original sources

Effect of maternal age on autosomal trisomies.

The effect of maternal age on the genesis of trisomy was studied by comparing data from 362 trisomic and 790 chromosomally normal spontaneous abortions. As a group the trisomies were associated with a substantial increase in maternal age but there were considerable differences in the magnitude of the effect for different trisomies. The effect of increasing maternal age was most pronounced for trisomies involving the small chromosomes, both acrocentric and non-acrocentric. However, trisomy 16 was conspicuously different from trisomies for all the other small chromosomes, both in the reduced importance of increased maternal age and in the high frequency with which it occurred. The effect of increasing maternal age on trisomies for chromosomes in groups A, B and C was less clear than that for the small chromosomes. However, the evidence suggested that trisomy for these chromosomes was associated with a moderate increase in maternal age. It was suggested that the maternal age-dependent trisomies might result from precocious disjunction of the bivalents and random segregation of the resulting univalents, a process which would affect chromosomes with the fewest number of chiasmata and which might be more prevalent if oocytes of older women. It was further suggested that true non-disjunction, that is, the failure of bivalents to separate at anaphase, might also result in the production of trisomies. This process might be independent of, or only slightly influenced by, increasing maternal age but be affected by the presence of large blocks of heterochromatin.

Abortion, Spontaneous↗

Spontaneous abortion and the use of sugar substitutes (saccharin).

The hypothesis that the use of saccharin may increase the risk of spontaneous abortion was tested in a case-control study. Women who had had spontaneous abortions were compared with women who had been delivered after 28 weeks' gestation. Women with a history of diabetes were excluded from the analysis. The use of sugar substitutes during pregnancy was similar in cases and controls: 5.5 per cent of cases and 5.8 per cent of controls reported using sugar substitutes. The power of the analysis to detect a twofold increase in the frequency of use of sugar substitutes in cases as compared to controls was approximately 81 per cent. The analysis effectively controlled for all known potentially confounding variables: that is, age at last menstrual period, history of previous spontaneous abortions, smoking during pregnancy, and usual weight were controlled in the analysis.

Abortion, Spontaneous↗

Induced abortion and spontaneous abortion: no connection?

The hypothesis that spontaneous abortion is associated with prior induced abortion is tested in an epidemiologic study. The reproductive histories of a consecutive series of women admitted to hospital with spontaneous abortions were compared with those of a control series of women who delivered after 28 weeks gestation. There is no association between spontaneous abortion and prior induced abortion. The power of the analysis to detect a 30% excess in the frequency of induced abortion in cases as compared to controls is 82% at alpha = .05. The design and analysis effectually controlled for all potentially confounding factors.

Abortion, Induced↗

Mosaic autosomal trisomy in cultures from spontaneous abortions.

In a consecutive series of 592 karyotyped spontaneous abortions, ten of 103 autosomal trisomies were mosaic, with a normal cell line also present. The frequency of mosaicism (10%) is much higher than that reported in Down syndrome, but similar to that reported in amniotic fluid cultures and in induced abortions. The most likely explanations for this discrepancy are (1) previous underestimation of mosaicism in live births or (2) mosaicism which is often restricted to extraembryonic fetal tissue.

Abortion, Spontaneous↗

Smoking: a risk factor for spontaneous abortion.

We compared cigarette smoking during pregnancy among 574 women who aborted spontaneously (cases) and 320 women with delivery after at least 28 weeks' gestation (controls). Log-linear analysis was used to test the hypothesis that smoking is associated with spontaneous abortion. Several potentially confounding variables--namely, age at last menstrual period and the number of previous pregnancies ending in spontaneous abortion, in induced abortion and in live birth--were controlled in the analysis. Women who had aborted spontaneously reported smoking during pregnancy more often than those with delivery after 28 weeks' gestation: 41% of cases and 28% of controls smoked. The odds ratio for the highly significant association with smoking was 1.8. The association did not vary with age or previous obstetric events. We conclude that smoking during pregnancy is a risk factor for spontaneous abortion.

Abortion, Spontaneous↗

Spontaneous abortion as a screening device. The effect of fetal survival on the incidence of birth defects.

To make sound inferences about the distribution, causes and risks of congenital anomalies requires an understanding of selective survival among fetuses. Studies of spontaneous abortions are therefore advocated. A simple model is proposed of the distribution, among spontaneous abortions and births, of conceptuses with and without anomalies. The resulting equation accomodates both maternal and fetal factors. Interaction between maternal and fetal factors is hypothesized, in the form of a maternal device for screening out anomalous conceptuses. A number of the known facts about congenital anomalies are shown to be plausibly interpreted in terms of the proposed model. Finally, some clinical and epidemiologic implications of the model for the study of spontaneous abortions are pointed out.

Abnormalities, Drug-Induced↗

The cusum test of homogeneity with an application in spontaneous abortion epidemiology.

We test the hypothesis of homogeneity over time in the rate of an event with a modification of Page's cumulative sum (cusum) procedure. The modification draws on an indifference zone approach to testing that is well suited to the epidemiologic study of retrospective data. We provide procedures for evaluating the significance level of the largest observed cusum value occurring in a sequence of fixed length. We draw inferences unconditionally with a known baseline rate of the event, and conditionally on observed margins with unknown baseline rate. Data collected over a five year period from one New York City hospital serve to illustrate the modified cusum test in a study of fluctuations in the proportions of chromosomally normal, trisomic, X-monosomic and triploid spontaneous abortions.

Abortion, Spontaneous↗

The Yugoslavia Prospective Lead Study: contributions of prenatal and postnatal lead exposure to early intelligence.

To investigate associations between the timing of lead (Pb) exposure on early intelligence, we examined the results of psychometric evaluations at ages 3, 4, 5, and 7 years, from 442 children whose mothers were recruited during pregnancy from a smelter town and a non-lead-exposed town in Yugoslavia. We compared the relative contribution of prenatal blood lead (BPb) with that of relative increases in BPb in either the early (0-2 years) or the later (from 2 years on) postnatal period to child intelligence measured longitudinally at ages 3 and 4 (McCarthy GCI), 5 (Wechsler Preschool and Primary Scale of Intelligence-Revised, WPPSI-R IQ), and 7 (Wechsler Intelligence Scale for Children-version III, WISC-III IQ), controlling for: Home Observation for Measurement of the Environment (HOME) quality; maternal age, intelligence, education, and ethnicity; and birthweight and gender. Elevations in both prenatal and postnatal BPb were associated with small decrements in young children's intelligence.

Analysis of Variance↗