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PubMed1992

Family history of reproductive cancers and ovarian cancer risk: an Italian case-control study.

The relation between family history of ovarian, breast, and endometrial cancer and risk of epithelial ovarian carcinoma was analyzed within the framework of a case-control study conducted from 1983 to 1989. The study included 755 cases of ovarian cancer and 2,023 controls in hospital for a spectrum of acute nongynecologic, hormonal, or neoplastic conditions in the Greater Milan area, Italy. Eighteen cases (2%) and 24 controls (1%) reported a history of ovarian cancer in a first-degree relative: The corresponding multivariate adjusted odds ratio (OR) was 1.9 (95% confidence interval (CI) 1.1-3.6). The risk of ovarian cancer was elevated in women reporting a family history of breast cancer (OR = 1.6, 95% CI 1.1-2.3), but no significant association emerged with a family history of endometrial cancer (OR = 1.3, 95% CI 0.8-1.7). When the data were stratified by family history of breast cancer, a family history of ovarian cancer was over 10 times more frequent in both cases and controls who reported a family history of breast cancer than in cases and controls reporting no family history of breast cancer. The estimated odds ratio for ovarian cancer associated with a family history of the disease was 2.3 (95% CI 1.1-4.5) in women not reporting a family history of breast cancer, but no association emerged in the subgroup of women reporting a family history of breast cancer. These results confirm that a family history of ovarian cancer increases the risk of the disease, but the percentage of ovarian cancer cases explained by a family history of the disease is small: Less than 1% of observed cases in this study could be attributed to this "family risk factor."

Adult↗
PubMed1989

Perimenopausal bone mass and risk factors.

We studied the effect of menopausal status and risk factors on lumbar bone mineral density (BMD) and metacarpal cortical thickness (MCT) in 286 women of 46-55 years of age. Body mass index (height/weight) was measured and the family history of osteoporosis, reproductive history, menopausal status, calcium intake, amount of physical activity and the consumption of tobacco and alcohol were assessed. Lumbar BMD and MCT decreased substantially in the perimenopausal and postmenopausal period. In the premenopausal women a significant (P = 0.03) lower lumbar BMD was observed in the lowest tertile of calcium intake (less than or equal to 900 mg/day) compared to the highest tertile (greater than or equal to 1200 mg/day). This difference was not apparent in the peri- and postmenopausal women. This suggests that dietary calcium intake is more important in the development and/or maintenance of peak bone mass, than in the modulation of postmenopausal bone loss. Apart from menopausal status and low calcium intake, no other significant determinant of bone mass could be identified. We conclude, therefore, that the assessment of risk factor status is not an efficient tool for the identification of perimenopausal women with low bone mass.

Bone Density↗
PubMed1996

Dietary risk factors for renal cell carcinoma in Denmark.

The role of diet in the aetiology of renal cell carcinoma was investigated in a population-based case-control study in Denmark. Cases were 20-79 years old, with a histologically verified diagnosis of renal cell carcinoma. Controls were sampled from the general population and were frequency-matched on age and sex. A total of 351 cases (73% of the eligible) and 340 controls (68% of the eligible) were included in the study. Dietary information was obtained in a self-administered food frequency questionnaire and the information was confirmed in a subsequent interview performed by trained interviewers who also elicited information on other suspected risk factors such as smoking, occupation, medical history, education and reproductive history. Logistic regression models were used to calculate the odds ratios, and, both frequency of consumption of various food stuffs and computed nutrients were examined. A positive association was observed between risk of renal cell carcinoma and total energy intake (odds ratio, OR, for highest quartile compared to lowest: 1.7 (95% confidence interval, CI, 1.0-3.0) for men, and 3.5 (95% CI 1.6-6.5) for women), fat intake (OR for highest quartile compared to lowest: 1.9 (95% CI 1.1-3.5) for men, and 3.3 (95% CI 1.6-6.9) for women). For women, an effect was also seen for intake of carbohydrates (OR for highest quartile compared to lowest: 3.2 (95% CI 1.5-6.8), while no protective effect was seen for vegetables or fruit. Dairy products may be associated with risk of renal cell cancer (OR for women using thickly spread butter compared to thinly spread: 11.4 (95% CI 2.8-45), OR for women who drank more than one glass of milk with 3.5% fat content compared to never drink milk: 3.7 (95% CI 1.2-11). As expected, total energy intake, intake of fat, protein and carbohydrates were closely correlated making it difficult to identify one of the energy sources as more closely associated with risk of renal cell cancer than the other. Several energy sources have been identified as possible risk factors for renal cell carcinoma. It is possible that a high energy intake as such rather than the individual sources are responsible for the increased risk. Furthermore, dairy fats may be associated with renal cell carcinoma risk. The observed associations appeared stronger in women, and did not explain the association with obesity and low socio-economic status previously found in Denmark.

Adult↗
PubMed1996

Heart transplantation is associated with an increased risk for pancreaticobiliary disease.

OBJECTIVE: To determine the risk factors for and the incidence, morbidity, mortality, and outcome of pancreaticobiliary disease in patients who have had orthotopic heart transplantation. DESIGN: Retrospective case-control analysis. SETTING: University hospital-based heart transplantation center. PATIENTS: 20 case-patients with pancreaticobiliary disease and 40 controls; all patients received heart transplants between 1985 and 1994. Controls were matched to case-patients by time of transplantation and length of survival. MEASUREMENTS: Charts were reviewed and data were extracted using a structured data abstraction protocol. Risk factors assessed before transplantation were cause of heart disease, history of diabetes, reproductive history, and sex. Risk factors assessed at presentation of pancreaticobiliary disease were weight change after transplantation, alcohol use, use of medications, recent total parenteral nutrition, age at symptom onset, recent rejection episode, cyclosporine level, complete blood count, time between transplantation and onset of symptoms, body mass index, calcium level, liver function test results before and at symptom onset, and lipid profile. RESULTS: Pancreaticobiliary disease occurred in 20 of 255 transplant recipients (7.8%). The incidence of disease in these patients within 1 year after transplantation was 3.9% compared with an expected rate of 0.2% per year (P < 0.01). A decreased serum calcium level was the only risk factor found to differ significantly between the two groups (mean +/- SD, 2.19 +/- 0.17 mmol/L in case-patients and 2.31 +/- 0.14 mmol/L in controls; P = 0.005). The duration of hospitalization for the treatment of pancreaticobiliary disease was longer for patients who received transplants than for patients who did not receive transplants and were treated at Temple University Hospital during a similar period (17.1 days compared with 7.2 days; P < 0.001). However, the outcome was excellent in most patients. CONCLUSIONS: Pancreaticobiliary disease occurs 17.4 times (95% CI, 9.2 to 32.7 times) more frequently in patients receiving transplants than in the general population. It is a seldom recognized but apparently common complication of orthotopic heart transplantation that results in substantial morbidity and health care resource use. Further study is needed to ascertain why this condition occurs and how the risk for developing it can be reduced.

Adult↗
PubMed2005

Biological and behavioral determinants of fertility in Tierra del Fuego.

The reproductive history of 182 women in postreproductive life or near menopause from the Chilean part of Tierra del Fuego was traced back by means of familial interviews. These postmenopausal women represent the population since almost the beginning of the settlement, and their reproductive years were spent on the island. Path analysis was applied to analyze fertility determinants of these women and to propose a complex model of interconnections among factors. The reproductive history of these women is characterized by a long fertile span, a short childbearing period, and low fertility. Age at menarche is relatively late, and the age of the women at first birth is mainly determined by their late age at marriage. The use of contraception is related to both spacing and stopping behaviors. The late age of women at marriage, the rhythm of conception, and practices of contraception are proposed as the main determinants of fertility in Tierra del Fuego.

Age Factors↗
PubMed1999

Reproductive risk factors for breast cancer by receptor status, histology, laterality and location.

It is well established that a woman's reproductive history influences her risk of breast cancer. We examined whether the effect of reproductive history was similar for different sub-types of breast cancer. The study was based on a population-based cohort of 1.5 million Danish women born between 1935 and 1978, with individual information on births. Between 1978 and 1994, 10,790 incident cases of breast cancer were identified in a nationwide cancer registry, including detailed information on receptor status, histology, laterality and location of the tumour. Overall, the incidence of breast cancer was 13% lower in parous compared with nulliparous women. This reduction was significantly stronger for mucinous than for ductal carcinomas and for tumours located centrally than for those non-central in the breast. Overall, the incidence in parous women increased by 10% by each 5-year postponement of their first birth. For the incidence of lobular carcinomas this increase was significantly stronger, and for mucinous carcinomas it tended to be stronger than for ductal carcinomas. For the incidence of centrally located tumours the increase was stronger than for non-centrally located tumours. On average, there was a 10% decrease in breast-cancer risk by each additional birth. This decrease was seen in most sub-types, but not for lobular carcinomas of for centrally located tumours. According to our findings, lobular and mucinous carcinomas and centrally located tumours may have risk-factor profiles that differ from other types of breast cancer.

Adolescent↗
PubMed2001

Risk factors for preterm premature rupture of membranes at Mulago Hospital, Kampala.

OBJECTIVE: To evaluate the epidemiological risk factors in patients admitted at Mulago Hospital with preterm premature rupture of the membranes from their socio-demographic characteristics and reproductive history. DESIGN: Cross-sectional case control study. SETTING: Labour ward, Mulago Hospital, Kampala, Uganda. METHODS: Cases were enrolled at admission while controls were enrolled after a term delivery not preceded by pre-mature rupture of the membrane (PROM). Controls were matched for age range (age +/- 2 years) and parity with the cases. A detailed history of socio-demographic characteristics, past medical and surgical illness and past reproductive history were obtained and data entered into a coded questionnaire. Endocervical swabs and amniotic fluid samples were taken from the cases during labour. Validity was assessed using Chi-square with a p-value of less than 0.05 considered significant. RESULTS: Maternal socio-demographic characteristics were similar for cases and controls. A history of hypertension, abortion, prior PROM, Caesarean section, cervical cerclage, cervical incompetence or abnormal vaginal discharge were significant risk factors for preterm PROM (p < 0.05). CONCLUSION: There are factors by which mothers at risk of preterm PROM can be identified before onset of rupture.

Abortion, Spontaneous↗
PubMedDate not supplied

Characteristics of cystic breast disease with special regard to breast cancer development.

BACKGROUND: This prospective study compares the characteristics of cystic disease of the breast (CDB) of patients who developed breast cancer (BCa) during the follow-up (1.25-4 years) period with those who did not. MATERIALS AND METHODS: K+, Na+, albumin, dehydroepiandrosterone (DHA), DHA-sulphate, oestrone, oestradiol, testosterone and progesterone levels were determined in breast cyst fluid (BCF). Patients presented data about their menstrual status, reproductive history, lactation period, date of first and the number of BCF aspirations, gynaecological interventions, use of oral contraceptives, family history of cancer, smoking habits and coffee consumption. The BCa incidence of patients was compared with the expected number of BCas in an age-matched group of 5143 women. RESULTS: Out of 147 patients 6 developed BCa. The standardized incidence rate was 6.29. There were significant differences in testosterone, oestrone and progesterone levels and also reproductive history of patients who developed BCa compared with patients without BCa. CONCLUSION: The above markers outline a subgroup of patients with the highest BCa risk.

Adult↗
PubMed1995

Does "incessant" ovulation increase risk for early menopause?

OBJECTIVE: We attempted to determine whether gynecologic histories differ in women who have and have not experienced an early menopause. STUDY DESIGN: A group of 344 "case" women whose average age at menopause was 42.2 years and an age-matched group of 344 "control" women still menstruating or menopausal after age 46 were selected from a survey of 10,606 women aged 45 to 54 years for interviews about their reproductive history. RESULTS: Case women were more likely to have had menarche at or before age 11, had shorter cycle lengths, had fewer pregnancies with live births, and had more frequent pelvic operations including unilateral oophorectomy and multiple cesarean sections. Case women had a greater number of presumed ovulatory cycles, as estimated from age at menarche, average cycle length, and years of anovulation associated with pregnancies or oral contraceptive use. In a multivariate model including smoking status and body mass index, ovulatory cycles were a significant predictor of early menopause, especially after an estimated 300 ovulations. CONCLUSION: The reproductive histories of women who experienced an early menopause suggest a pattern of more rapid oocyte loss ("incessant" ovulation).

Case-Control Studies↗
PubMed1998

Are overweight women at increased risk of obesity following pregnancy?

Longitudinal studies suggest that women who already have a high BMI are at greater risk of maternal obesity than their lighter counterparts. The aim of the present study was to investigate this possibility by examining the relationship between reproductive history and maternal BMI in a community of 627 women from South Africa with a high prevalence of obesity. Standardized questionnaires were used to obtain detailed sociodemographic and behavioural information, while maternal weight and height were both measured at the time of the interview. Analysis of covariance (ANCOVA) showed that maternal age (r2 0.015, P = 0.001), smoking status (r2 0.012, P = 0.036), and social support (r2 0.011, P = 0.006) were all independently associated with maternal BMI. If overweight women were at increased risk of maternal obesity, then the positive relationship between reproductive history and maternal BMI should be enhanced in this relatively obese community, yet the ANCOVA models showed no independent association between gravidity and maternal BMI after controlling for the effects of confounding factors. Although previous longitudinal studies have found a positive association between prepregnant weight and long-term weight gain, this relationship might arise because overweight women gain more weight over a fixed period of time than normal weight women, and therefore they may appear to be at greater risk of pregnancy-related weight gains. Overweight women are at greater risk of weight gain generally, but there is little unequivocal evidence to suggest that they are at any increased risk of maternal obesity, when compared with women of lower BMI.

Adult↗
PubMed1996

Reproductive characteristics of a population of urban Swiss women.

OBJECTIVE: To describe the variability of reproductive life, from menarche to menopause, in the Geneva female population. DESIGN: Women's Health Survey, 1992-1993. SETTING: Mobile epidemiology unit of a University Hospital. SUBJECTS: One thousand and thirty-two women aged 30 to 74 years, resident in Geneva, Switzerland. MAIN OUTCOME MEASURE: Menstrual and reproductive history. RESULTS: A 'typical' woman of Geneva has her menarche at 13 years, regular 28 day cycles with 5 days of menstrual flow. She is 26 years old when she first gives birth and has her last baby (which is typically the second) at age 31. She has 37 years of potential fecundity and a natural menopause at age 50. In addition, 11% of the women have tried to be pregnant during two years without success, 67% have ever used oral contraceptives, 20% had a first birth at age 30 or more and 23% were nulliparous. Younger women reported earlier ages at menarche. Women with lower education tended to be a younger age at the birth of her first child. CONCLUSIONS: In this first study of the reproductive characteristics of women in Geneva, nulliparity and a late first birth appeared unusually frequent, especially when compared with American or Chinese women. The observed distributions of reproductive history are compatible with the very high incidence rate of breast cancer in the Geneva population.

Adult↗
PubMed2005

[Proximal determinants of fertility: reproductive behavior among Chamibida indigenous women in Antioquia, Colombia].

The aim of this study was to determine the reproductive timing used by Chamibida indigenous women in Antioquia, Colombia. This socio-demographic study used the reproductive history technique and was conducted in the year 2000. Two hundred and thirty-four homes on the Cristianía indigenous reservation were visited to obtain 253 reproductive histories (83.1% of the women ages 15 to 49). Reproductive behavior was characterized by sexual debut at age 17.8 years (mean), with short intergenesic intervals in 69.0% and an adjusted fertility rate of 5.12 children. This reproductive pattern differs from all other indigenous groups and subgroups in Antioquia. As an explanation, Chamibida women are familiar with and accept Western birth control methods, besides having more access to formal schooling. Current Colombian health system policies are far from appropriate, since they fail to take the indigenous groups' specificities into account.

Adolescent↗
PubMedDate not supplied

[Iron deficiency anemia among Mexican women on reproductive age. History of an unresolved problem].

OBJECTIVE: To describe the prevalence of iron deficiency anemia in the past 66 years among Mexican women on reproductive age, and to analyze the efficacy of interventions implemented for its prevention and control. MATERIAL AND METHODS: Observational and clinical epidemiological studies as well as federal intervention programs published between 1939 and 2005 having original data related to anemia were reviewed using electronic databases (Medline and Artemisa) and manual searches. Keywords were anemia, iron deficiency, women, and Mexico. The quality of clinical trials was evaluated using the Jadad scale. Anemia prevalence tendency was analyzed using a linear regression weighted according to the sample size. RESULTS: Forty-six research studies were included, nine corresponded to clinical trials and four to federal-operative programs. Seventeen papers reported anemia prevalence in non-pregnant women and twenty-three in pregnant women. In the first group, weighted anemia prevalence had decreased from 39.6 to 15.5%, whereas in pregnant women it decreased from 35 to 25%. Of the clinical trials, 55% were considered to be good quality studies. CONCLUSIONS: Anemia in women on reproductive age, particularly in pregnant women, is still a public health problem in Mexico. If the current conditions continue, it would take 57 years to eradicate anemia in non-pregnant and 121 years in pregnant women. It is necessary to evaluate intervention policies and conduct consistent studies in order to enable appropriate steps to be taken to control anemia.

Adult↗
PubMed2003

Isolation of Toxoplasma gondii from goats with history of reproductive disorders and the prevalence of Toxoplasma and chlamydial antibodies.

The prevalence of antibodies to Toxoplasma gondii and Chlamydia psittaci was assessed in goats with a history of abortion, stillbirth and neonatal mortality. Antibodies were detected in 540 (30%) and 57 (3.2%) goats out of 1799 tested by indirect haemagglutination and complement fixation tests, respectively. Toxoplasma gondii was isolated for the first time in Botswana from 22 out of 81 sets (27.2%) of foetal tissues, maternal and foetal cotyledons and uterine tissues of goats which had previously aborted or given birth to stillborn or weak kids that died within two days of birth. These results implicate T. gondii and C. psittaci, but especially the former, to be associated with caprine reproductive problems and require appropriate control measures.

Abortion, Veterinary↗
PubMed2002

Genetic mating systems and reproductive natural histories of fishes: lessons for ecology and evolution.

Fish species have diverse breeding behaviors that make them valuable for testing theories on genetic mating systems and reproductive tactics. Here we review genetic appraisals of paternity and maternity in wild fish populations. Behavioral phenomena quantified by genetic markers in various species include patterns of multiple mating by both sexes; frequent cuckoldry by males and rare cuckoldry by females in nest-tending species; additional routes to surrogate parentage via nest piracy and egg-thievery; egg mimicry by nest-tending males; brood parasitism by helper males in cooperative breeders; clutch mixing in oral brooders; kinship in schooling fry of broadcast spawners; sperm storage by dams in female-pregnant species; and sex-role reversal, polyandry, and strong sexual selection on females in some male-pregnant species. Additional phenomena addressed by genetic parentage analyses in fishes include clustered mutations, filial cannibalism, and local population size. All results are discussed in the context of relevant behavioral and evolutionary theory.

Animals↗
PubMed1978

Fetal loss, gravidity, and pregnancy order.

An investigation of the reproductive history of 3068 women doctors showed that the risk of fetal loss at a given pregnancy order varied with their gravidity--that is, the total number of pregnancies that has occurred before the survey. Fetal loss rates in even the first pregnancy varied with eventual gravidity in a J-shaped manner. They fell from 12.4% in women with only one pregnancy at the time of the study, to 5.7% in women with two, and then increased steadily to 36.8% in those with six pregnancies. This variation in risk remained when allowance was made for the incomplete nature of some of the reproductive histories. When gravidity was held constant, fetal loss rates decreased with each successive pregnancy. This finding conflicts with previous suggestions that the risk of fetal loss increase with pregnancy order and age.

Abortion, Spontaneous↗
PubMed1989

Lower prevalence of non-reproductive system cancers among female former college athletes.

Lower prevalence of non-reproductive system cancers among former college athletes. Med. Sci. Sports Exerc., Vol. 21, No. 3, pp. 250-253, 1989. The prevalence (lifetime occurrence) rates of cancers of nonreproductive organs and tissues were determined for 5,398 living alumnae, 2,622 of whom were former college athletes and 2,776 who had been nonathletes, from data on medical history, reproductive history, athletic training, and diet. The non-reproductive system cancers were divided into two classes: class I, which included cancers of the digestive system, thyroid, bladder, lung, and other sites and hematopoietic cancers (lymphoma, leukemia, myeloma, and Hodgkin's disease), and class II, which included skin cancers and cutaneous melanoma. The former college athletes had a significantly lower prevalence of class I cancers compared to the nonathletes; the age-adjusted relative risk (RR) equals 3.34, 95% confidence limits (1.35, 8.33), P = 0.009. In contrast, the prevalence rates of malignant melanomas and skin cancers did not differ significantly between the former athletes and nonathletes. The age-adjusted RR did not differ from 1.0. The lower prevalence rate of class I cancers among the former athletes is in accord with previous findings of a significantly lower prevalence rate of breast cancer and cancers of the reproductive system among former college athletes compared to nonathletes.

Adult↗