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The prevalence of RTIs in 600 married females (15-44 yrs.) representing 12 subcentre villages of Daurala block of Meerut was 35.3%. The reproductive tract infections were significantly associated with place of last delivery (P< 0.001), person conducted the last delivery (P< 0.001) and in women had history of abortions (P< .005).
In order to explore the relationship between spastic diplegia and mothers' previous reproductive loss, 119 cases of spastic diplegia born between 1953 and 1977 were compared with two series of controls. One control group comprised a random sample of all births, the other a random sample of births matched for birthweight and length of gestation. A demonstrable difference in previous reproductive histories was found between mothers of cases of spastic diplegia and mothers of the first series of controls, but there was no such difference between mothers of cases and mothers of the second series. This suggests that the reproductive histories of mothers of cases of spastic diplegia are not unique, and that their unusual number of reproductive losses is related to the child's associated fetal growth-retardation and not to the presence of diplegia.
Menstrual and reproductive history of 178 women referred to the thyroid clinic was compared with 49 healthy controls. Cases were classified as euthyroid, hypothyroid or hyperthyroid after clinical examination and after serum T3, T4, TSH measurements. Reproductive history was related chronologically to symptoms and signs of thyroid dysfunction. Only 31.8% of hypothyroid and 35.3% of hyperthyroid women had normal menstrual pattern in contrast with 56.3% of Euthyroid and 87.8% of healthy controls (p < 0.001). Reproductive failure (infertility, pregnancy wastage, failure of lactation) occurred in 37.5% of hypothyroid and 36.5% of hyperthyroid cases against 16.3% of euthyroid and 16.7% of healthy controls (p < 0.05). Interestingly, in 45% of cases with menstrual abnormality, the anomaly was antecedent to other clinical features by a variable period of two months to ten years. Reproductive failure and lactation failure also preceded thyroid dysfunction or goitre. Reproductive dysfunction may therefore be considered as one of the presenting symptoms of thyroid disorders in women, keeping in mind both menstrual irregularities and lactation failure may also arise from other common or idiopathic origins. Especially in women with menstrual irregularities in the perimenopausal age if thyroid dysfunction is detected, pharmacotherapy may be a superior alternative to surgical interventions like hysterectomy.
A case-control study is reported of reproductive history and colorectal cancer risk based on information obtained from interviews with white women 40--79 years old who were admitted to Roswell Park Memorial Institute between the years 1957 and 1965. Women with the primary diagnosis of carcinoma of the colon (n = 284) and carcinoma of the rectum (n = 270) did not differ significantly in their prior reproductive histories as compared to those of a control group of women (n = 1,763) with nonneoplastic diseases not affecting the breast or reproductive sites. The peritinent literature suggesting a parity--colorectal cancer association in women is reviewed. The conclusion reached is that the evidence for a parity-colorectal cancer association is equivocal; but that if such an association exists, it is probably weaker than that seen for cancers of the breast, ovary, and uterine corpus.
Epidemiological studies of in situ breast cancer are sparse, and the role of reproductive history, an established risk modifier for invasive breast cancer, remains incompletely investigated. To examine possible associations with parity and age at first birth, we undertook a case-control study nested in a nationwide cohort of Swedish women. The reproductive history of 1,368 women aged 65 or younger with a diagnosis of carcinoma in situ of the breast were compared with that of 6,837 age-matched controls drawn randomly from a population-based Fertility Registry. Statistical analyses were performed by conditional logistic regression. Compared to nulliparous women, ever-parous women were at a reduced risk of carcinoma in situ of the breast. The risk decreased with number of live births, with the estimated risk reduction in the highest parity group (5+), being of the same magnitude as that reported for invasive breast cancer. By contrast, a positive association with increasing age at first birth was somewhat less pronounced than that observed previously in the same data set with respect to invasive breast cancer. Our findings indicate that parity affects the risk of invasive breast cancer and carcinoma in situ similarly, whereas the effect of age at first birth appears to be weaker for the risk of carcinoma in situ.
OBJECTIVE: To assess whether subsequent pregnancies increase the risk of recurrent stroke and whether the occurrence of an ischemic stroke affects reproductive history. METHODS: The authors identified 489 consecutive women aged 15 to 40 years with a first-ever arterial ischemic stroke or cerebral venous thrombosis from the record system of nine French neurologic centers. Information on stroke recurrence and reproductive history was obtained by means of chart review, written questionnaire, and telephone interview. RESULTS: Data were analyzed from 441 women (373 with arterial ischemic stroke and 68 with cerebral venous thrombosis). During a mean follow-up of 5 years, 13 arterial recurrent ischemic strokes occurred. There were no cases of recurrent cerebral venous thrombosis. The overall risk of recurrence was 1% within 1 year and 2.3% within 5 years. The risk of recurrence was significantly higher in patients with stroke of definite cause. Eleven recurrent strokes occurred outside pregnancy (absolute risk of recurrence = 0.5%; 95% CI 0.3, 0.95) and two during pregnancy or the puerperium (absolute risk of recurrence = 1. 8%; 95% CI 0.5, 7.5). The relative risk of recurrence was significantly higher during the postpartum period (risk ratio = 9.7; 95% CI 1.2, 78.9) than during pregnancy (risk ratio = 2.2; 95% CI 0. 3, 17.5) itself. The outcome of the 187 subsequent pregnancies was similar to that expected from the general population. Thirty-four percent of women indicated that they would have desired more pregnancies after their initial stroke. The main reasons for not considering pregnancy were concern of a recurrent stroke, medical advice against pregnancy, and residual handicap. CONCLUSION: Young women with a history of ischemic stroke have a low risk of recurrence during subsequent pregnancies. The postpartum period, not the pregnancy itself, is associated with an increased risk of recurrent stroke. The outcome of pregnancies in these women appears to be similar to that expected in the general population. A previous ischemic stroke is not a contraindication to a subsequent pregnancy.
BACKGROUND: Survivors of childhood cancer are at risk for secondary breast cancer. Other than previous chest radiation therapy, risk factors for secondary breast cancer have not been established. OBJECTIVE: To identify risk factors for breast cancer among female survivors of childhood cancer. DESIGN: Retrospective cohort study. SETTING: The Childhood Cancer Survivor Study (CCSS), a multicenter study of persons who survived more than 5 years after childhood cancer diagnosed from 1970 to 1986. PARTICIPANTS: Among 6068 women in the CCSS, 95 women had 111 confirmed cases of breast cancer. MEASUREMENTS: Standardized incidence ratios for breast cancer were calculated by using age-specific incidence rates in the general population. Breast cancer incidence was evaluated with respect to primary cancer diagnosis and therapy, age at and time since primary diagnosis, menstrual and reproductive history, and family history of cancer. RESULTS: Breast cancer risk was increased in survivors who were treated with chest radiation therapy (standardized incidence ratio, 24.7 [95% CI, 19.3 to 31.0]) and survivors of bone and soft-tissue sarcoma who were not treated with chest radiation therapy (standardized incidence ratios, 6.7 and 7.6, respectively). Family history of breast cancer (relative rate, 2.7 [CI, 1.3 to 5.0]) and history of thyroid disease (relative rate, 1.7 [CI, 1.1 to 2.6]) were independently associated with increased risk, and exposure to pelvic radiation was protective (relative rate, 0.6 [CI, 0.4 to 0.9]). Age at primary cancer diagnosis and menstrual and reproductive histories did not statistically significantly modify risk. LIMITATIONS: This cohort has not yet attained an age at which breast cancer risk is greatest. CONCLUSION: Survivors of childhood sarcomas and those who received chest radiation therapy are at risk for secondary breast cancer. When assessing a survivor's risk, clinicians should consider primary diagnosis, previous radiation therapy, family cancer history, and history of thyroid disease.
The purpose of this study was to assess risk factors associated with a history of hysterectomy among Mexican-American women living in the United States Southwest. Mexican-American women ages 20-74 at time of interview were defined as a subpopulation among adults in the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984. Language preference, reproductive history, level of education, poverty status, generation of immigration, marital status, and insurance coverage were examined in relation to risk of hysterectomy using weighted tabulation and logistic regression for data resulting from complex survey designs. Heretofore, language preference has not been a variable considered in relation to risk of hysterectomy. In the HHANES, over 60% of women who spoke English most often rather than Spanish reported a history of hysterectomy. Women who had previously been pregnant were almost four times as likely (odds ratio 3.972) to have had a hysterectomy compared to women who had never been pregnant. Women who expressed any preference for English were twice as likely (odds ratio 2.050) to have had a hysterectomy than were those who responded that they exclusively preferred Spanish. Age, higher levels of education, and higher economic status also increased the risk of hysterectomy. In contrast, reproductive history, marital status, prior tubal ligation, generation of immigration, and health insurance did not have substantial effects on the risk of hysterectomy. This study suggests that, in the future, the effect of language preference should not be overlooked when considering risk factors for hysterectomy.
BACKGROUND: Systemic lupus erythematosus (SLE) is designated by the Japanese government as one of the intractable diseases and all patients, who suffer from these diseases, are registered to get financial aid for treatment. Using newly registered SLE patients, a case-control study was conducted to evaluate potential risk factors. METHODS: Two-hundred and eighty-two women SLE patients, newly registered to receive financial aid for treatment, and 292 randomly selected health examination participants at public health centers (controls) were surveyed from April 1988 through March 1990. By means of a self-administered questionnaire, data concerning demographic variables, smoking and drinking habits, past medical and reproductive history, and family history were collected. RESULTS: Based on unconditional logistic regression analysis, the risk of SLE was significantly increased for current smokers (age-adjusted odds ratio (OR) = 2.31, 95% confidence interval (CI) 1.34-3.97). Alcohol and milk intake were inversely associated with risk. Family histories of asthma and collagen diseases, including SLE, were associated with significantly elevated risk of SLE (OR = 2.07, 95% CI 1.14-3.77; OR = 5.20, 95% CI 1.08-24.95, respectively). Regarding reproductive function, women with menarche at age 15 or later had significantly higher risk than those, who started menstruating before age 12 (OR = 3.82, 95% CI 1.66-8.81 for menarche at > 15 years and OR = 2.90, 95% CI 1.14-7.39 for menarche at > or = 16y). CONCLUSIONS: Our study suggests several risk factors, including smoking, family history, and reproductive history that may increase the risk of SLE.
The New South Wales perinatal data collection was used to examine the association between low birth-weight and some of its potential risk factors. The study population comprised all recorded singleton births to residents of NSW in 1987. Low birth-weight infants were categorized as either small for gestational age (SGA) or preterm (less than 37 weeks). Risk factors were analyzed separately for these categories. The risk factors examined were primarily demographic or reproductive history variables. Univariate analysis and multivariate logistic regression were used to evaluate the risk factors. The factors associated with SGA birth were mainly demographic (maternal age, parity, marital status, socioeconomic status, and ethnic group) while those associated with preterm birth had more reproductive history variables (maternal age, parity, marital status, prior spontaneous abortion, prior induced abortion, prior stillbirth or neonatal death, sex of infant). A first antenatal visit after 12 weeks had a statistically significant but small effect on both SGA and preterm birth.
OBJECTIVE: to analyse the prevalence of cervical chlamydia infection and its determinants in an Italian population of women attending outpatients services for contraceptive counselling or routine gynaecological examination. METHODS: between November 1989 and November 1990 we conducted a cross-sectional study on the prevalence of cervical Chlamydia trachomatis infection among women attending the outpatients service of seven university clinics in Northern (three centres), Central (three centres) and Southern (one centre) Italy. Eligible for the study were subjects with symptomatic low gynaecological tract infection (a total of 2071 women), a history of recurrent abortions (two or more miscarriages and no livebirth (416 subjects)), or sterility (371 subjects), plus a sample of asymptomatic women observed for contraceptive counselling or routine gynaecological examination identified on randomly selected days at the participating centres (1321 subjects). During the gynaecological consultation women were asked about their general characteristics, reproductive history, contraceptive and sexual habits, and history of sexually transmitted diseases (STD) using a standard questionnaire. An endocervical specimen was obtained with a plastic swab. The direct smear immunofluorescent antibody test (IFA test) was used to detect chlamydia antigens. RESULTS: out of the 2071 women with genital infection, 104 (5.0%) had cervical chlamydia infection; the corresponding percentages were 4.6 (19/416), 5.4 (20/371) and 3.9 (51/1321) respectively in women with recurrent abortions, sterility and in asymptomatic subjects. The risk of chlamydia infection was higher in women reporting a history of STD: in comparison with those without a history of STD, the relative risk of chlamydia infection was 1.4 (95% confidence interval, CI, 1.0-2.0). Among women reporting current use of a contraceptive method the risk of cervical chlamydia infection was lower in current users of barrier methods; in comparison with oral contraceptive users, the RR was 0.4 (95% CI, 0.2-0.8) in barrier methods users and 0.5 (95% CI, 0.2-1.1) in intrauterine device or other methods users. No consistent relationship emerged with age, reproductive history or number of sexual partners over the last 12 months. CONCLUSION: in this Italian population the frequency of cervical chlamydia infection appeared to be lower than in other selected groups from Northern European and American countries. Users of barrier contraception methods were at reduced risk of infection.
Habitual abortion and premature delivery are occasionally associated with a bicornuate or septate type of uterus when the abnormality is severe. A considerable improvement of reproductive performance was seen in patients who underwent plastic operation of the uterus. The procedures introduced by Strassman, Jones and Tompkins were used. Although it is still difficult to compare the postoperative reproductive history of these three surgical procedures, the procedure used by Tompkins may be technically more simple and provides for an easier entrance into the endometrial cavities in order to incise the common lower uterine segment. Primary sterility still remains a controversial indication for metroplasty and the postoperative reproductive history for this is poor.
The aim of this work is to analyze the distribution of Duffy blood group and the reproductive history of 148 malformed newborns and their mothers compared to 131 control pairs. The mother-child segregation of the system is analyzed using ITO matrixes. A higher frequency of heterozygote mothers for the system was found among the malformed group compared to controls. No differences in the reproductive history was found between Duffy system homozygote or heterozygote mothers.
The incidence of DMBA-induced mammary carcinomas in Sprague-Dawley rats depends upon their previous reproductive histories. Young virgin rats (YV) are highly susceptible to the carcinogen, while old virgin rats (OV) are less susceptible, and parous rats (P) are resistant. The authors performed endocrinologic studies in these three groups of rats in order to determine whether the different susceptibility to carcinogenesis, according to the reproductive history, is or is not related to the hormonal milieu. The pituitary, the ovaries, the adrenals, and the mammary glands were processed for light microscopy. Pituitary prolactin (PRL), follicle-stimulating hormone, and luteinizing hormone cells were immunostained by peroxidase-antiperoxidase and quantitated with an image analyzer. Radioimmunoassays of serum and pituitary PRL and serum estradiol were also done. The results showed no differences in the hormonal milieu of YV, OV, and P rats at the time of carcinogen treatment. Several changes were observed after DMBA administration, the most conspicuous being 1) hyperplasia of pituitary PRL cells, 2) high serum PRL levels, 3) nodular hyperplasia of the adrenal cortex, 4) high serum estradiol levels, and 5) lack of adrenal necrosis in P rats and some OV rats. These modifications did not correlate with the degree of susceptibility of YV, OV, and P rats to carcinogenesis, supporting the concept of the importance of the mammary gland differentiation at the moment of carcinogen administration. (Am J Pathol 1982, 109:47-56).
To assess the relationship between circulating leptin concentrations, metabolic parameters, and lifestyle factors such as alcohol intake, physical activity level, smoking habits, and reproductive history, a cohort of 359 women was drawn from a population-based study conducted in Victoria, Australia. The parameters measured included body mass index (BMI); waist and hip circumference; blood pressure; and fasting glucose, insulin, triacylglycerol, cholesterol, and leptin concentrations. In addition, a self-administered questionnaire was used to assess reproductive history, physical activity level, alcohol intake, and smoking habits. Our results demonstrated that BMI, body weight, waist circumference, and hip circumference were all strongly correlated with circulating leptin concentrations in this population (r > 0.56, P < 0.001 in all cases). Waist/hip ratio, triacylglycerols, insulin, glucose, and cholesterol were also associated with leptin (P < 0.05), but there was no association between leptin and age, height, or blood pressure. When these associations were adjusted for BMI, age, glucose, and waist circumference were significantly associated with leptin. The lifestyle factors examined did not help to explain the observed variation in leptin concentrations between individuals when results were adjusted for degree of adiposity and age.
The reproductive history and the present health status of 66 patients who had had a pregnancy complicated by hypertension during the period 1972-1982 were retrospectively studied. Hypertension in pregnancy is a poor prognostic factor not only for the future development of hypertension but, also, as it is associated to a very poor reproductive history. Such complications are more frequent in pregnant women with very high blood pressure (greater than 160/100). In fact, in the case of a previous pregnancy, this group of patients had experienced a high rate of abortions (31.7%), premature deliveries (17.8%) and perinatal mortality (21.4%). Moreover, these women are subject to a higher risk (56.5%) of developing hypertension in successive pregnancies. Risk factors for determining the future development of hypertension are: familiar hypertension, the severity of hypertension during pregnancy and pluriparity.
This report describes the prevalence and pattern of exercise during pregnancy among US women. It is based on 9953 randomly selected women who gave birth to live infants in 1988 and participated in the National Maternal and Infant Health Survey, a cross-sectional survey with a stratified systematic sampling in 48 states, the District of Columbia, and New York City. Self-reported exercise before and during pregnancy, specific activities, and number of months of exercise were examined in relation to maternal demographic characteristics, reproductive history, and prenatal care. Forty-two percent of all women reported exercising during pregnancy, half of whom exercised longer than 6 months. Walking was the leading activity (43% of all activities reported), followed by swimming (12%) and aerobics (12%). Older mothers and women who had multiple gestations, previous children, or an unfavorable reproductive history were less likely to exercise during pregnancy. Given this high prevalence of exercise in pregnancy, more research is warranted on both the beneficial and adverse maternal and fetal effects of exercise in pregnancy.
We measured serum levels of estradiol (E2), sex hormone-binding globulin SHBG), progesterone, and dehydroepiandrosterone sulfate (DHEAS) in 61 postmenopausal women drawn from female residents in a community in Japan to evaluate the relationships between these hormone levels and potential breast cancer risk factors. The information on reproductive history, body size, alcohol use, and physical activity was obtained by means of a self-administered questionnaire. There was a significant trend in increasing E2 level with increasing height after taking account of age and body mass index (BMI) (p for trend = 0.04). BMI was inversely associated with SHBG level after controlling age (p for trend = 0.01). Decreasing progesterone with increasing BMI was observed after controlling age and history of hysterectomy (P = 0.05). Alcohol consumption was positively associated with E2 level and there was a strong linear trend after controlling for age, height, and BMI (p for trend = 0.001). Trend for increasing DHEAS with alcohol consumption was also statistically significant after controlling for age and history of hysterectomy (p for trend = 0.01). Reproductive factors as well as physical activity were not related to any of the hormone levels.