[Induced abortions in relation to the use of contraceptive agents].
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Abortion, Induced↗
Biomedical subjects
L B Knudsen
Publications and source records attributed to L B Knudsen.
Birth control: some experiences from Denmark.
This article discusses that an effective birth control exists in Denmark today. Birth control is considered as a means for the couple not only to reach the wished-for family size by limiting their number of children but also to decide when to have children. Since 1973, women in Denmark can have an induced abortion on request before the end of the 12th week of pregnancy. An increasing proportion of women applying for induced abortion have no children, indicating that induced abortion is a means to obtain an effective postponement of first birth. The paper concludes that birth control is primarily accomplished by use of contraceptives and as an effect of widespread use, teenagers have managed to diminish their total rate of pregnancy rather dramatically.
Abortion, Induced↗
Infant mortality in Denmark and Sweden. A comparison based on data in two national registries.
OBJECTIVES: To study in detail the differences in infant mortality between Denmark and Sweden. STUDY DESIGN: Data retrieved from national health registers on infant death rates were compared for 1980-1988, supplemented with a study on the impact of socio-economic conditions in 1985-86 (Denmark) or 1986 (Sweden). RESULTS: Even after stratification for maternal age, parity, and socio-economic group, the Danish mortality rate was higher in all age-at-death intervals except for stillbirths. Maternal age-parity distribution was more favourable in Denmark, the socio-economic distribution in Sweden. The most marked country differences was seen in young women. The difference in the rate of perinatal deaths but not of later deaths is explainable by a more favourable birth weight distribution in Sweden than in Denmark. CONCLUSIONS: The studied variables do not explain the difference in mortality risk but it may be due to life style factors so far not identified.
Birth Weight↗
Perinatal outcome after leave of absence from work for twin-pregnant women.
AIM: To evaluate the association between the incidence of leave of absence from work and perinatal outcome for the twin-pregnant woman. MATERIAL AND METHODS: A 20.2% sample of all twin-pregnant women between 1982 and 1988 (1,331/6,602) was taken at random from the entire material of twin deliveries in Sweden, archived at the Medical Birth Registry (MBR), National Board of Health and Welfare. For each woman in the sample, information on period(s) and reasons for leave of absence from work during pregnancy was obtained by inquiry to all Regional Health Insurance Offices throughout Sweden. A comparison of perinatal outcome was also made with information from the Danish Fertility Database and the Norwegian Medical Birth Registry. RESULTS: Duration of leave from work increased from 58 days in 1982 to 97 days in 1988 (trend analysis; t = 7.9, p < 0.001). No association was seen between perinatal mortality for twins weighing < 1,500 g and changes in the incidence of leave of absence. The incidence of twins with a birthweight < 1,500 g varied among the three countries, increasing significantly only in Sweden (trend analysis chi 2 = 20.3, p < 0.0001). CONCLUSION: Although the number of days of leave of absence increased by 60%, there was no obvious association with perinatal mortality for twins weighing < 1,500 g. The incidence of Swedish twins with a birthweight < 1,500 g increased significantly, indicating that the effect of leave of absence from work on perinatal outcome may be less effective than previously thought.
Female↗
Induced abortions in Denmark.
BACKGROUND: A law on Induced Abortion on Request came into force in Denmark in 1973. During the first years the rate of abortion increased but since the early 1980s the rate has been rather constant. The paper reviews recent findings concerning induced abortion and discusses its role in controlling fertility. METHODS: Trends in induced abortion is described from routine statistics while information on the aborting women are taken both from a survey and from a register based study of fertility- and abortion-pattern among a cohort of women. RESULTS: Fertility trends in Denmark are characterized by an increasing age at first birth. Half of the aborters to day have no children before and 10% had given birth less than 18 months earlier. Among aborters a higher proportion than among parturients were still under education and a higher proportion were single with no steady partner. Half of the aborters became pregnant in spite of contraceptive use, indicating a need for better contraceptives. CONCLUSIONS: Induced abortion has become a generally accepted form of birth control in Denmark and the decision to terminate a pregnancy is influenced by many factors including the woman's conjugal--and educational situation. A strategy for prevention of induced abortion must take into consideration the social circumstances of women and for families with children.
Abortion, Induced↗
Glucagon-like peptide-1-(9-36) amide is a major metabolite of glucagon-like peptide-1-(7-36) amide after in vivo administration to dogs, and it acts as an antagonist on the pancreatic receptor.
This study assesses the importance of metabolites formed following exogenous administration of glucagon-like peptide-1-(7-36) amide (GLP-1). After subcutaneous (s.c.) administration of GLP-1 to dogs the plasma immunoreactivity of GLP-1 measured by two different radioimmunoassays (RIAs) were higher than that measured by a sandwich enzyme-linked immunosorbent assay (ELISA). This discrepancy was due to the formation of the metabolites GLP-1-(9-36) amide, GLP-1-(7-35) and GLP-1-(7-34). Receptor binding studies using baby hamster kidney cells expressing the human pancreatic GLP-1 receptor showed that the affinity of GLP-1-(9-36) amide, GLP-1-(7-35) and GLP-1-(7-34) was 0.95%, 12% and 2.8%, respectively, of the affinity of GLP-1-(7-36) amide. Furthermore, GLP-1-(9-36) amide was shown to be an antagonist to adenylyl cyclase activity, whereas GLP-1-(7-35) and GLP-1-(7-34) were shown to be agonists. GLP-1-(9-36) amide was shown to be present in vivo in amounts up to 10-fold that of GLP-1-(7-36) amide. Due to its low binding affinity, this antagonistic metabolite does not seem to be able to cause physiological antagonism upon s.c. administration of the peptide.
Animals↗
[Women in medical research. National Institutes of Health].
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Clinical Trials as Topic↗
Risk of testicular cancer after vasectomy: cohort study of over 73,000 men.
OBJECTIVE: To confirm or refute reports that vasectomy may increase the risk of cancers of the testis and prostate. DESIGN: Computerised record linkage study of cohort of men with vasectomy and comparison of cancer rates with those in the whole Danish population; manual check of all records of patients with testicular and prostate cancer diagnosed within the first year of follow up. SETTING: Denmark 1977-89. SUBJECTS: Cohort of 73,917 men identified in hospital discharge and pathology registers as having had a vasectomy for any reason during 1977-89. MAIN OUTCOME MEASURES: Observed incidences of testicular, prostate, and other cancers up to the end of 1989. RESULTS: The overall pattern of cancer incidence in the study cohort was similar to that expected nationally. No increased incidence in testicular cancer was observed (70 cases; standardised morbidity ratio 1.01 (95% confidence interval 0.79 to 1.28)). The incidence during the first year of follow up was also close to that expected (nine cases; standardised morbidity ratio 0.80 (0.36 to 1.51)). The incidence of prostate cancer was not increased (165 cases; standardised morbidity ratio 0.98 (0.84 to 1.14)). CONCLUSIONS: The incidence of testicular cancer in men with vasectomy is no higher than in other men. Vasectomy does not cause testicular cancer and does not accelerate the growth or diagnosis of pre-existing testicular neoplasms. Data concerning a causal relation between vasectomy and prostate cancer were inconclusive.
Adult↗
Structure-activity studies of glucagon-like peptide-1.
A series of analogs of glucagon-like peptide-1 (GLP-1) was made replacing each amino acid with L-alanine to identify side-chain functional groups required for interaction with the GLP-1 receptor. In the case of L-alanine being the parent amino acid, substitution was made with the amino acid found in the corresponding position in glucagon. Binding assays were performed using the cloned rat GLP-1 receptor, and receptor activation was monitored using RIN 2A18 plasma membranes. The analogs that showed the weakest receptor binding were further compared with native GLP-1 by circular dichroism spectroscopy to investigate possible conformational changes. We conclude that the side chains in positions 7, 10, 12, 13, and 15 are directly involved in the receptor interaction while positions 28 and 29 are important for GLP-1 to adapt the conformation recognized by the receptor.
Adenylyl Cyclases↗
International study of sex ratio and twinning of neural tube defects.
The goal of this study, based on information collected from eight congenital malformation registry programs around the world, was to analyze sex and twinning of affected infants and fetuses, according to type of neural tube defect (NTD) and other variables. The type of defect and its location, whether it occurred in isolated form or was associated with other malformations, population from which data were retrieved, vital status of the infant, and gestational age of the fetus/infant were considered. The material included 3,416 infants and 168 selectively aborted fetuses with anencephaly, 4,830 infants and 76 fetuses with spina bifida, and 1,022 infants and 19 fetuses with encephalocele. Less than 20% of infants with anencephaly or spina bifida and more than one-third of infants with encephalocele had associated malformations. A female excess was found among all infants with NTD but a male excess in fetuses delivered spontaneously before week 20, indicating selective male late fetal deaths. Sex ratio varied by type of NTD, vital status at birth, presence of associated malformations, and year of birth, with an increasing sex ratio for anencephaly during the 1960s and 1970s. Twinning was positively associated with NTD but the extent of this association varied with NTD type and program, while the distribution by sex type of pair of twin appeared to be similar to that of all births. Twins concordant for anencephaly or encephalocele were mainly found when the defect occurred as part of a syndrome, and only in like-sexed pairs. Twins concordant for spina bifida had the isolated form of the defect and 5 of 6 pairs were like-sexed.(ABSTRACT TRUNCATED AT 250 WORDS)
Diseases in Twins↗
[Information on parity in the medical registry of births of the National Board of Health. Validation with the help of a new fertility database in Danish Statistics].
Information on parity from the Medical Register of Births kept by The Danish National Board of Health was compared with a parity value calculated with the aid of a new, individual-based Fertility Database compiled by the Danmarks Statistik. The parity information contained in the Medical Register of Births is recorded by the midwife at each birth, where the woman's number of previous live-births is noted. The Register on Population Statistics records live-born infants with reference to their mother, and parity is calculated in the Fertility Database on the basis of these records. The results show a very high degree of accordance between the two measures of parity. More than 99.5% of women with parity one who have given birth since 1978 are classified as such by both systems. Due to an ambiguity in the midwife's birth notification form there has previously been uncertainty regarding the classification of first-time mothers based on the information contained in the Medical Register of Births. This evaluation shows that this information can be regarded as valid.
Birth Rate↗
Vasectomy and testicular cancer: epidemiological evidence of association.
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Adult↗
Monitoring dominant germ cell mutations using skeletal dysplasias registered in malformation registries: an international feasibility study.
Using data from seven malformation monitoring systems around the world, the feasibility of monitoring fresh dominant mutations using skeletal dysplasias was explored. Based on a total of over 9.5 million births, 1500 infants with skeletal dysplasias were identified (16 per 100,000). In spite of efforts to get exact diagnoses, an average of 21% were unspecified. Comparisons of rates of specific diagnoses in different programmes suggested that classification differed. By analysing maternal age distribution, estimates were made of the proportion of fresh mutations in different subgroups: conditions regarded as dominant (achondroplasia, thanatophoric dysplasia, spondyloepiphyseal dysplasia) were estimated to consist of 58% fresh mutations--some of the remaining cases were inherited, others were probably misclassified. Among conditions regarded as recessive, only 5% were estimated to be truly dominant mutations. In the total group of skeletal dysplasias, 21% were estimated to be fresh dominant mutations and if osteogenesis imperfecta were excluded, the figure was 31%. By power analyses it was shown that equal monitoring power may be obtained by a programme covering about 45,000 births per year with intensive diagnosis of each individual case of skeletal dysplasia and a programme some three times greater where no specific diagnoses are obtained. An increasing trend in the occurrence of skeletal dysplasias was seen but probably explained by changing ascertainment. An impact of antenatal diagnosis resulting in a decrease in occurrence was also apparent in some programmes.
Adult↗
Socioeconomic differences in fetal and infant mortality in Scandinavia.
This study demonstrates that socioeconomic differences do exist in all three Scandinavian countries, and these differences have implications for perinatal and infant survival. Using parental education as a proxy for socioeconomic conditions, the association with perinatal survival seems to be stronger in Denmark and Norway than in Sweden. For postneonatal mortality the association is equally strong in the three countries. Data from one of the countries (Norway) demonstrates the joint importance of parental education, and the association with paternal education is equally strong as that with maternal education. If father and mother have the lowest level of education, their offspring has 50 to 80% higher perinatal and infant mortality risks. These observations call for further research into the association between social variables and health in order to tease out causal relationships which might lead to future preventive actions.
Educational Status↗
Absence of limbs and gross body wall defects: an epidemiological study of related rare malformation conditions.
The study is based on almost 10 million births and reports on 215 infants with two unusual malformations: amelia and gross body wall defect. Amelia without body wall defect was present in 116 cases, 67 had body wall defects without amelia, and 32 had both. The total rate was 2.2 per 100,000 births. The infants were divided into five mutually exclusive groups. There were 40 infants (0.4 per 100,000) with agenesis of the body stalk, 18 with amelia and other types of gross body wall defects (0.2 per 100,000), 56 with amelia and malformations other than gross body wall defects (0.6 per 100,000), 41 with amelia (with or without other limb reduction defects) but no nonlimb malformations (0.4 per 100,000), and 60 infants with gross body wall defects of a type other than agenesis of body stalk and without amelia (0.6 per 100,000). A weak trend of decreasing prevalence of these malformations was found during the observation period. Infants with agenesis of the body stalk and infants with amelia combined with other types of gross body wall defects occurred at an increased rate in infants of young women. This maternal age effect is also found with gastroschisis, but not with omphalocele, and may indicate etiological or pathogenetic similarities between gastroschisis and the two former groups of defect. In infants with amelia, additional limb reduction defects could be of any type: transverse, longitudinal, or intercalary. Therefore, amelia may be the end result of different types of disturbances of limb morphogenesis. There was an increased rate of twinning. The relationship with amniotic band syndrome is discussed.
Abdominal Muscles↗
The cyclops and the mermaid: an epidemiological study of two types of rare malformation.
Infants with cyclopia or sirenomelia are born at an approximate rate of 1 in 100,000 births. Eight malformation monitoring systems around the world jointly studied the epidemiology of these rare malformations: 102 infants with cyclopia, 96 with sirenomelia, and one with both conditions were identified among nearly 10.1 million births. Maternal age is somewhat increased for cyclopia, indicating the likely inclusion of some chromosomally abnormal infants which were not identified. About half of the infants are stillborn. There is a female excess among infants with cyclopia. Excess twinning occurred for cyclopia and possibly also for sirenomelia. An analysis of associated malformations indicates the similarity between the two conditions, which is in agreement with recent embryological analysis.
Abnormalities, Multiple↗
Sudden infant death syndrome (SIDS) in Denmark: evaluation of the increasing incidence of registered SIDS in the period 1972 to 1983 and results of a prospective study in 1987 through 1988.
To investigate a reported increase, from 0.4 to 1.3 per thousand live births, in the Danish incidence of sudden infant death syndrome (SIDS), a retrospective analysis of SIDS in Denmark from 1972 to 1983 was carried out. Based on data registered with the National Board of Health, a notable regional difference in SIDS rate between the western and eastern parts of Denmark was found. This difference did not correlate with the overall postneonatal mortality by region. Danish law requires medicolegal investigation in all cases of sudden unexpected death. Medicolegal autopsies are performed only in the three forensic institutes which cover all of Denmark. Despite the law and a uniform organization of the forensic medical services, differing application of postmortem examinations and individual interpretation of the history and autopsy in cases of sudden infant death existed. Differences in reporting of respiratory infections, suffocation, and cardiac malformation were found to contribute to the increase and to regional disparities in SIDS incidence. The three Danish forensic institutes examined all cases of sudden infant deaths in Denmark 1987 and 1988. These cases were classified as explained cause of death, pure SIDS, and atypical SIDS; atypical cases were evaluated by consensus. The SIDS incidence (the number of classic SIDS and atypical SIDS per thousand live births) was 1.9 in 1987 and 1.3 in 1988, and it was identical in the eastern and western part of Denmark; however, a higher incidence both of overall postneonatal and SIDS mortality was found in the middle region of Denmark.(ABSTRACT TRUNCATED AT 250 WORDS)
Autopsy↗
[Births and abortions during 1985-1989].
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Abortion, Legal↗