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Biomedical subjects

S Harlap

Publications and source records attributed to S Harlap.

At least 73 records · Page 4Linked to original sources
PubMed1982

Sex of offspring of women using oral contraceptives, rhythm, and other methods of birth control around the time of conception.

Sex ratios were studied in a cohort of 33,205 newborns whose mothers had been questioned in early pregnancy about contraceptive use around the time of conception., The proportion of males was 0.517 (95% confidence limits [CL], 0.512 to 0.522). In the 9279 offspring of women who had used oral contraceptives (OC) in the 5 months prior to conception the sex ratio was 0.517 (0.507 to 0.527). There are sufficient numbers available for study for us to be 95% certain that OC causes no shift in sex ratio of 1% or more. Women who conceived within 2 months of stopping the pill had a small excess of males (0.528; 95% CL, 0.510 to 0.546), but this excess was probably due to chance. OC failures were followed by a raised sex ratio in the offspring (0.543; 95% CL, 0.509 to 0.577), and this excess of males was observed consistently in subgroups of maternal age, parity, race, and education. Failures of rhythm contraception were also associated with a consistent excess of male births (0.567; 95% CL, 0.514 to 0.620). No changes were observed after failures of IUDs, barrier, or chemical methods.

Adult↗
PubMed1982

Ectopic pregnancies: rising incidence rates in Northern California.

In a population of about 300,000 Northern California women aged 15--44, the age-adjusted incidence of ectopic pregnancy rose from 55.5 to 84.2/100,000 women, 1972--1978. The ratio of ectopics to 1,000 deliveries-plus-spontaneous abortions rose from 9.4 to 14.8. The change occurred mainly in women under age 30, and was observed in seven of the eight hospitals in the area. There was no alteration in the frequency of hospitalized pelvic inflammatory disease (PID); salpingitis decreased over the years studied; and tubal sterilization events remained constant at around 0.9 per cent per year of women aged 15--44.

Abortion, Spontaneous↗
PubMed1982

Seasonal changes in plasma lipid and lipoprotein levels in Jerusalem.

Seasonal variations were observed for fasting total plasma cholesterol, high-density lipoprotein-cholesterol (HDL-C), estimated low-density lipoprotein-cholesterol (LDL-C), and the ratio of HDL-C to total cholesterol (TC), measured in 5,244 middle-aged men and women in Jerusalem. HDL-C was highest in winter and lowest in summer, and triglycerides showed a mirror image of this pattern. TC and LDL-C followed a more complex wave form, levels of these being high in the winter, decreasing to a trough in the summer and increasing rapidly to a peak in the autumn. The ratio of HDL-C to TC was lowest in early autumn and highest in winter and early spring. There were two- to fivefold changes in the prevalence of hypercholesterolemia, hypertriglyceridemia and high LDL-C according to the season of examination. These findings imply that clinicians should take season into account when diagnosing hyperlipidemia and when evaluating apparent success or failure in its treatment. Studies of lipid distributions and of interventions aimed at lipid modification need to consider the potentially confounding effects of season.

Cholesterol↗
PubMed1982

The Jerusalem Lipid Research Clinic: sampling, response and selected methodological issues.

The Jerusalem Lipid Research Clinic examined 8,646 17-yr-old youngsters and 6,952 of their parents in order to obtain information on the distribution of plasma lipids and lipoproteins in the free-living multiethnic population of Jerusalem. Sampling procedures and recruitment methods are described, and the degree to which the study population was representative of the target population is addressed in detail. Sources of response bias, although not likely to have influenced the results of analyses to date, are identified, and biased portions of the sample will be excluded from further analyses. Selected methodological problems unique to the Jerusalem Lipid Research Clinic are discussed.

Adolescent↗
PubMed1982

Plasma lipids and lipoproteins in adult Jews of different origins: the Jerusalem Lipid Research Clinic prevalence study.

Plasma cholesterol, triglyceride (TG) and high-density lipoprotein-cholesterol (HDL-C) were measured in a cross-sectional sample of 6,952 middle-aged Jerusalem residents in 1976-79, using the protocols and methods of the North American Lipid Research Clinics (LRC) prevalence studies. There were highly significant variations between groups of Jews of different origin. Age-adjusted levels of total cholesterol were about 10 mg/dl higher in European- and Israeli-born men and women than in immigrants from North Africa or Asia. TG levels showed a similar pattern in men, but the reverse in women. HDL-C levels were 2 to 4 mg/dl higher in European- and Israeli-born women than in female immigrants from Asia or North Africa. In men there was little variation of HDL-C by origin, but males showed significant ethnic differences in the proportion of HDL-C in total cholesterol, while females did not.

Adult↗
PubMed1982

Contributions of different lipoprotein fractions to variations in total cholesterol between Israeli origin groups and social classes.

Total cholesterol, triglycerides and high-density lipoprotein (HDL)-cholesterol were measured in 2,306 boys, 1,716 girls, 2,479 fathers and 2,822 mothers examined on Visit 1 of the Jerusalem Lipid Research Clinics Prevalence Study in 1976-79. Low-density lipoprotein (LDL)-cholesterol levels were estimated from the other three measurements. Using multiple regression analysis to control for body mass index, social class, season of the year and (in parents) age, we compared the three origin groups (Asian, North African and European, depending on the birthplace of the parents) with the Israeli-born group. In both fathers and mothers, the lower total cholesterol levels in the North African group, and to a lesser extent in the Asian, were explained mainly by lower LDL-cholesterol in these groups. In youngsters, the origin groups were characterized by differences not only in LDL-cholesterol, but also in other lipoprotein fractions. Social class in youngsters and mothers was associated mainly with the HDL-cholesterol fraction; in fathers it was associated only with triglycerides. Possible relationships of these findings to smoking, alcohol, exercise and female sex hormones are discussed.

Adolescent↗
PubMed1982

Association of blood pressure with ethnic origin in 17-year-olds: the Jerusalem Lipid Research Clinic Prevalence Study.

Blood pressure and pulse rate were measured in a random sample of 1,200 17-yr-old Jewish boys and girls examined in 1976-79 during Visit 2 of the Lipid Research Clinic Prevalence Study. Mean systolic pressures were 110.1 and 106.1 mm Hg in boys and girls, respectively, diastolic pressures 69.9 and 70.4, pulse pressure 40.2 and 35.7, pulse rates 73.3 and 77.3 beats/min, and double products 8,082 and 8,228 mm Hg x beat x min-1. Multiple regression analysis showed that there were significant differences in systolic pressures between boys and girls whose fathers had immigrated from different countries, pressures being highest in those of European origin and lowest in those of North African origin. These differences were of the order of 3 to 4 mm Hg and were not explained by the distribution of height, Quetelet index, skinfold thickness, smoking, drinking, social class or education of subject. Pulse pressures followed a similar pattern, but the differences between origin groups were significant only for boys. Diastolic pressures and pulse rates did not vary with origin.

Adolescent↗
PubMed1981

Should coitus late in pregnancy be discouraged?

Coitus late in pregnancy has been thought to be a cause of premature rupture of membranes, preterm birth, and amniotic fluid infections. In this study, data on 10 981 singleton, low-risk pregnancies were examined. The mothers were asked at time of delivery if there were any months when they did not have sexual intercourse during pregnancy. Pregnancy outcomes were determined by medical record review. Those having intercourse showed no increased risk of premature rupture of membranes, low birthweight, or perinatal death at any gestational age. Women abstaining from intercourse had more unfavourable outcomes in the seventh and eighth months, but these differences were almost eliminated by adjustment for maternal age. Preterm delivery was no more frequent in those having intercourse than in those abstaining. These findings challenge the view that intercourse late in pregnancy is harmful.

Adult↗
PubMed1981

Complications of pregnancy and labor in former oral contraceptive users.

Complications of pregnancy and delivery, and obstetric interventions, were studied in a sample of Israeli women questioned post-partum about contraceptive use. The 2,953 women who had used the pill were compared with 13,630 controls. There were no significant differences between users and controls in the frequencies of bleeding in pregnancy, premature rupture of membranes, placenta previa, placental abruption, fetal distress or asphyxia, ABO incompatibility, hydramnios, transverse lie, cephalopelvic disproportion, and persistent occipitoposterior or post-partum hemorrhage. New cases of hypertension, varicose veins, thrombophlebitis, urinary tract infection, and cervicitis were reported in primigravidae and multigravidae without past histories of these conditions; there were no differences between oral contraceptive users and controls other than an excess of cervicitis in primigravidae among former users. There was a slight decrease in normal deliveries in former oral contraceptive users due to an increase in inductions of labor. On the other hand, rates of forceps and vacuum deliveries, caesarian sections, and interventions in the third stage did not differ between former oral contraceptive users and controls. These results indicate that former oral contraceptive users can anticipate the same frequency of complications of pregnancy and labor as women who have used other, or no, methods of contraception.

Age Factors↗
PubMed1981

Scoring newborns for the risk of subsequent hospital admissions: comparative findings in Jerusalem and Haifa.

Six demographic and health characteristics of newborn infants were used to develop an additive risk score for predicting first admissions to hospitals during their first two years of life. The scoring system, developed for a cohort of 5,243 infants in Haifa, identified an at-risk group comprising 23% of the population, in whom 43% of hospital admission events occurred. The same scores, applied to a cohort of 5,800 infants in Jerusalem, identified an at-risk group comprising 22% of the population and predicted 35% of hospital admission events. Possible reasons for the differences between the two cities are discussed.

Birth Order↗
PubMed1981

The effect of abortion method on the outcome of subsequent pregnancy.

Infants born to women following a previous induced abortion, primarily by the D&C method, showed an excess of low birth weight. However, when women with medical illnesses were excluded, the excess was very slight. The data suggested that the greater the dilatation at D&C, the lower the birth weight. Women requiring induced abortions should have them as early as possible to minimize cervical damage and its consequences.

Abortifacient Agents, Nonsteroidal↗
PubMed1980

Alcohol, smoking, and incidence of spontaneous abortions in the first and second trimester.

32,019 women completed a questionnaire on alcohol use at their first antenatal visit; thereafter they were followed to assess the incidence of spontaneous abortions. 51.7% reported drinking no alcohol in early pregnancy; 44.7% had less than 1 drink daily; and 2.4, 0.4, and 0.1% had an average of 1-2, 3-5, or more than 6 drinks respectively. Life-table analysis showed that the age-adjusted relative risks of second-trimester losses (15-27 weeks) were 1.03 (not significant: ns), 1.98 (p < .01), and 3.53 (p < .01) for women taking less than 1, 1-2, and more than 3 drinks daily, compared with non-drinkers. The corresponding relative risks for first-trimester losses (5-14 weeks) were 1.12 (ns), 1.15(ns), and 1.15(ns). Smokers had relative risks of 1.01(ns) and 1.21(ns) in the first and second trimesters, compared with non-smokers. The increased risk of second-trimester miscarriage in drinkers was not explained by age, parity, race, marital status, smoking, or the number of previous spontaneous or induced abortions. Thus alcohol may harm human fetuses not only when it is abused but also when taken in moderation.

Abortion, Spontaneous↗
PubMed1980

Spontaneous foetal losses in women using different contraceptives around the time of conception.

Spontaneous losses between the 5th and 27th weeks of pregnancy were measured in a prospective study of 32 123 women whose contraceptive history around the time of conception was known. Diaphragm use prior to conception was associated with a significant reduction in second-trimester losses, after taking into account the effects of age, parity, race, marital status, alcohol use, and previous spontaneous or induced abortions. Women who used oral contraceptives and stopped them more than one month prior to their LMP experienced a deficit of first-trimester losses but conceptions occurring immediately after stopping the pill were followed by a small but nonsignificant increase in spontaneous abortions. After oral contraceptive failures there was an increase in first-trimester losses, but no change in the incidence of second-trimester ones. IUD failures were followed by a significant two-fold increase in the risk of both first and second-trimester losses: no differences were detected between the different brands.

Abortion, Spontaneous↗
PubMed1980

Births following oral contraceptive failures.

Neonatal outcome was studied in 108 infants conceived while their mothers were taking oral contraceptives. The infants tended to be born to younger, less educated mothers and were more likely to have been exposed to hormonal pregnancy tests. Ten newborns were malformed; 8 of these were males. One was anencephalic, and 1 infant had Down's syndrome. There was also a significantly large number of twins and an excess of perinatal mortality. These results are similar to those of previous studies, showing a small but increased risk of adverse outcome in infants born after oral contraceptive failure.

Abnormalities, Drug-Induced↗
PubMed1980

Plasma high-density lipoprotein cholesterol, total cholesterol and triglyceride levels in 17-year-old Jewish residents of Jerusalem: a preliminary report. The Lipid Research Clinics Program Prevalence Study.

Preliminary data on plasma high-density lipoprotein (HDL) cholesterol, total cholesterol and triglyceride levels in 2565 teenage Jerusalem residents attending a military medical examination were analyzed. Mean HDL cholesterol levels were highest among male and female subjects whose fathers had immigrated from Europe and the Americas and lowest in those of Asian and of North African origin. Second-generation Israelis ranked intermediate between the Europeans and the other two groups. Total cholesterol levels were lowest in teenagers of both sexes whose fathers had come from North Africa, highest in subjects of European and of Israeli origin and intermediate in the Asians. Triglyceride levels were also lowest among North Africans of both sexes, but the Asian and Israeli groups had higher mean values than the Europeans. These findings show that patterns of lipid and lipoprotein levels previously observed in adult immigrants persist in a generation of native-born Israelis.

Adolescent↗
PubMed1979

A prospective study of spontaneous fetal losses after induced abortions.

The incidence of spontaneous abortions was observed among 31,917 women followed from their first prenatal visit. Life-table analysis showed that losses in the first trimester were not significantly affected by previous induced abortions, nor was any change in the risk of second-trimester losses detected among the 1493 parous women who reported having had induced abortions after childbirth. There was, however, an increase in the incidence of midtrimester losses among the 2019 nulliparous women with previous induced abortions; the age-adjusted rate of loss was 59.9 per 100,000 women at risk per day, as compared with 24.2 among the 12,042 control nulliparous women (P less than 0.001). The relative risk increased with the number of previous induced abortions and was not explained by the distribution of demographic and social variables. The risk decreased from 3.27 (95 per cent confidence limits, 1.72 to 6.23) after abortions induced before 1973, mainly by dilation and curettage, to 1.42 (0.76 to 2.65) after those done since 1973, when the more gentle technic of cervical dilation by use of laminaria was introduced. These findings indicate that there is little or no risk of spontaneous abortions after induced abortions when performed by current technics.

Abortion, Induced↗
PubMed1979

Gender of infants conceived on different days of the menstrual cycle.

The baby's sex was studied in 3658 births to Jewish women who observed the orthodox ritual of sexual separation each month and who resumed intercourse within two days of ovulation. The day of resuming intercourse relative to ovulation was estimated from the characteristics of each woman's menstrual cycle and the number of days of sexual abstinence observed after the last menstruation. The proportion of male babies was significantly higher (65.5 +/- 3.9 per cent, mean +/- S.D.) in the offspring of women who resumed intercourse two days after ovulation. This proportion tended to be lower on or near the day of ovulation than on the previous one or two days. These results, which were consistent in different demographic subgroups, demonstrate that insemination on different days of the menstrual cycle does lead to variations in sex ratio. Couples should be cautioned against attempting to conceive a boy by delaying intercourse until after ovulation, until further research has established whether delayed fertilization causes birth defects.

Educational Status↗