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PubMed1994

Ebstein's malformation of the tricuspid valve: genetic and environmental factors. The Baltimore-Washington Infant Study Group.

Ebstein's anomaly is a specific structural deformity of the tricuspid valve, and its rarity has hampered etiologic evaluation. Cases of Ebstein's anomaly registered in the Baltimore Washington Infant Study (BWIS), a regional case-control study of cardiovascular malformations (CVM) in infancy, are reviewed. Between 1981 and 1989 a total of 4,390 CVM cases, including 47 Ebstein cases, and 3,572 controls were registered. The prevalence of Ebstein's anomaly was 5.2 per 100,000 livebirths. Additional cardiac anomalies were present in 38.3% of Ebstein cases. Non-cardiac malformations were present in 19.1% of Ebstein cases vs. 25.5% of other CVM, and 1.7% of controls. Case-fatality by 1 year of age was 23.4% in Ebstein vs. 18.1% in other CVM. Interviews of parents of Ebstein cases, other CVM, and controls (n = 44, 3,335, and 3,572, respectively) elicited information on family history of malformations, maternal illnesses, reproductive history, therapeutic drugs, parental lifestyle, and environmental exposures during the periconceptional period. Case-control analyses suggest genetic, reproductive, and environmental risk factors: twins [odds ratio (OR) 8.2, 95% confidence interval (CI) 2.6-25.3]; family history of CVM (OR 6.4, 95% CI 1.8-22.2); white race (OR 2.9 with non-whites as reference, 95% CI 1.2-7.0); previous miscarriages (OR 2.0, 95% CI 1.2-3.3); maternal exposure to benzodiazepines (OR 5.4, 95% CI 1.5-19.1); and varnishing (OR 3.4, 95% CI 1.3-9.1). Additional multicenter investigations are warranted to elucidate the role of genetic, reproductive, and environmental factors in the etiology of this anomaly.

Adult↗
PubMed1996

Menstrual and reproductive factors and hip fractures in post menopausal women.

OBJECTIVES: We analyzed the relationship between menstrual and reproductive history and risk of hip fractures in post-menopausal women using data from an Italian case-control study. METHODS: Cases were 206 post-menopausal women admitted for fractures of the hip proximal femur to a network of teaching and general hospitals in Milan, Italy. The comparison group consisted of 590 post-menopausal women admitted to the same network of hospitals for acute, non-neoplastic, non-hormone-related conditions, other than traumatic or orthopedic disorders. Odds ratios (OR) of hip fracture were derived from unconditional multiple logistic regression. RESULTS: No relation emerged between risk of hip fractures and age at menarche, lifelong menstrual cycle pattern and age at menopause. In comparison with women with age at menopause > or = 53 years, the multivariate OR of hip fractures were 1.2, 1.1, 1.2 and 0.5 in women with menopause at 50-52, 45-49, 40-44 and before 40 years (X2(1) trend 0.21). In comparison with nulliparae, the estimated age-adjusted OR was 0.6 (95% confidence interval, CI, 0.4-0.9) for parous women, but the multivariate estimate was not significant (OR 0.8, 95% CI 0.6-1.3) and the multivariate trend in risk with number of births was not significant either. No relation emerged between hip fractures and age at first and last birth, and history of abortions. CONCLUSIONS: This study found no relevant influence of menstrual and reproductive factors on the risk of hip fractures in post-menopausal women. However, this is not in contrast with the observation of a short-term effect of menopause and more in general. female hormone levels on osteoporosis and hence on hip fractures.

Abortion, Induced↗
PubMed1977

Changes in menstrual cycle length and regularity after use of oral contraceptives.

This is an analysis of changes in menstrual cycle length and regularity occurring for a group of 211 women who had discontinued use of oral contraceptives. The analysis is based on prospectively recorded histories from the Menstruation and Reproduction History Program. Post-pill menstrual cycle length and regularity are compared with pre-pill averages. In the first post-pill cycle, there was an average increase of 6 days in cycle length. In subsequent cycles, however, cycle length and regularity were comparable to pre-pill norms in most cases.

Adult↗
PubMed1998

Reproductive health hospitalizations among women with human immunodeficiency virus infections.

OBJECTIVE: Our goal was to determine types of inpatient admissions among human immunodeficiency virus-infected women both before and after the human immunodeficiency virus diagnosis, so that we might outline opportunities for intervention. STUDY DESIGN: A total of 292 human immunodeficiency virus-infected women were interviewed about the reproductive history and prior hospitalizations. A reproductive health hospitalization was defined as either an obstetric admission or a gynecologic admission. Other admissions were categorized as either human immunodeficiency virus related, possibly human immunodeficiency virus related, or not human immunodeficiency virus related. Assignments were made independently by two human immunodeficiency virus specialists. If there was a conflict, a third reviewer was used. RESULTS: In the 10 years before study entry 44.4% of women had at least one obstetric admission, 30.4% had at least one gynecologic admission, 3.1% had at least one human immunodeficiency virus-related admission, 18.1% had at least one admission that was possibly human immunodeficiency virus related, and 13.3% had at least one admission that was not human immunodeficiency virus related. Overall, 226 (77%) women had been admitted to the hospital; of these, 201 (69%) had been admitted for reproductive health reasons. Similar patterns were seen in the year before diagnosis and the time after diagnosis. Reproductive health admissions were more common among women who were younger, who used drugs, and who had higher CD4+ cell counts. CONCLUSION: Women with human immunodeficiency virus infection are often admitted to hospitals for reproductive health reasons before and after the human immunodeficiency virus status is known. Clinicians providing reproductive health care must be actively engaged in efforts to reduce the heterosexual and perinatal transmission of human immunodeficiency virus, to identify human immunodeficiency virus-infected women early in the course of the disease, and to provide ongoing care to human immunodeficiency virus-infected women.

Adult↗
PubMed1989

The relation of polychlorinated biphenyls to birth weight and gestational age in the offspring of occupationally exposed mothers.

The authors studied the relation of polychlorinated biphenyls (PCBs) to birth weight and gestational age among the live offspring of women occupationally exposed to PCBs during the manufacture of capacitors in Upstate New York. Interviews were conducted in 1982 with 200 women who had held jobs with direct exposure and 205 women who had never held a direct-exposure job in order to ascertain information on reproductive history and other factors influencing reproductive outcome. Exposure was assessed as high-homolog PCB (Aroclor 1254), a continuous exposure variable estimated from an independently derived prediction model. After adjustment for variables other than gestational age known to influence birth weight, a significant effect of high-homolog exposure is seen for birth weight (slope of the regression beta = -33 g/unit change in natural logarithm (In) estimated serum PCB; 90% confidence interval (CI) -59 to -7; p(1) = 0.02). For gestational age, a small but significant decrease is also observed with an increase in estimated exposure (beta = -1.1 days/unit change in In estimated serum PCB; 90% CI -2.0 to -0.1; p(1) = 0.03). When gestational age is accounted for in addition to other variables related to birth weight, estimated serum PCB is no longer a significant predictor of birth weight (beta = -24 g/unit change in In estimated serum PCB; 90% CI -49 to 2; p(1) = 0.06). The authors conclude that these data indicate that there is a significant relation between increased estimated serum PCB level and decreased birth weight and gestational age, and that the decrease in birth weight is at least partially related to shortened gestational age. The magnitude of these effects was quite small compared with those of other known determinants of gestational age and birth weight, and the biologic importance of these effects is likely to be negligible except among already low birth weight or short gestation infants.

Birth Weight↗
PubMed1991

Family history of cancer in a female cohort population in Japan.

This study was aimed at examining the effect of familial predisposition on cancer incidence in a cohort population. Family history (FH) of cancer and reproductive history were obtained by a simple questionnaire from about 40,000 participants in a cervical cancer screening program visiting screening clinics in 1977. Number and age structure of family members were not known. About 40% of subjects reported positive FH which was not medically verified. Comparing the observed and expected numbers of pair-wise combination of various cancers observed among the family members, we found more intense cluster of cancers of the same than different sites. This population was followed until 1987 by using the population-based cancer registry and 638 cancer cases were detected. By matching residence and birth year, the same number of nonaffected controls was chosen from the original cohorts. Positive effect of FH was detected for large bowel and breast cancers, but not for stomach and cervical cancers. Older age at marriage and lower parity were noted for breast cancer cases.

Adult↗
PubMed1987

[Familial predisposition to cancer: a cohort study of participants in a cervical cancer screening program].

A numerous number of case-control studies have already demonstrated a certain extent of familial clustering for most human cancers. This is the first report of follow-up study with respect to familial predisposition to cancer. About 40 thousands women who participated in a cervical cancer screening program in 1977 were followed up until 1985 by using the population-based cancer registry. Cancer patients who were detected in the cohort population and their controls were compared for the family history of cancer and female reproductive history both of which had been recorded in a computer file beforehand. For large bowel cancer and breast cancer, positive effect of familial predisposition was observed, though not statistically significant.

Adult↗
PubMed1995

[Polyhydramnios and its relationship with congenital malformations: ultrasonographic diagnosis].

We analyzed the occurrence of polyhydramnios during pregnancy and to indicate the association with congenital abnormalities of the product and maternal alterations. A retrospective descriptive and transversal study was performed which included 6087 pregnant patients who were submitted to ultrasonographic studies from January 1, 1991 to December 31, 1993. The final sample consisted of 72 patients with criteria of polyhydramnios and who had a complete, clinical history, specific data concerning the reproductive history and maternal risk factors associated with polyhydramnios and fetal malformations was compiled. The occurrence of polyhydramnios during pregnancy was 1.1% and the association with congenital malformations was 13.8%, being the majority neural tube defects. The maternal alterations were related in 13.7% to polyhydramnios, being primary cause gestational diabetes. Anencephalia presented a significant statistics (p < 0.05). The occurrence of polyhydramnios is low in obstetric patients. Neural tube defects such as anencephalia are the primary fetal defects. Gestational diabetes and multiple gestations are the more significant maternal alterations.

Adolescent↗
PubMed2001

Menstrual and reproductive factors for subarachnoid hemorrhage risk in women: a case-control study in nagoya, Japan.

BACKGROUND AND PURPOSE: We sought to examine the relationship between menstrual and reproductive factors and the risk of subarachnoid hemorrhage (SAH), using a case-control study. METHODS: Cases consisted of a consecutive series of 124 women patients with first spontaneous SAH aged 30 to 79 years and confirmed aneurysm(s) by angiography and/or CT scan. Hospital and community controls subjects were identified, matched to each case by age (+/-2 years). RESULTS: Increased SAH risk was associated with (1) earlier age at menarche (adjusted odds ratio [OR]=3.24 for age <13 years compared with age >/=13 years; 95% CI, 1.25 to 4.03) and (2) nulligravidity (adjusted OR=4.23; 95% CI, 1.05 to 7.56). No significant association of SAH risk was found with regularity of menstrual cycle, age at pregnancy, age at first birth, and number of births. The greatest risk was for the combined effect of nulligravidity and earlier menarche (<13 years) (adjusted OR=6.37; 95% CI, 1.12 to 36.2). CONCLUSIONS: The combined effect of several variables related to menstrual and reproductive history may exert a greater influence on risk of SAH compared with a single menstrual or reproductive variable.

Adult↗
PubMed2004

Life-history correlates of steroid concentrations in wild peripartum baboons.

Steroid concentrations during late pregnancy and early lactation may be affected by both a female's reproductive history and her current condition, and may in turn predict subsequent life-history events, such as offspring survival. This study investigated these relationships in a wild primate population through the use of fecal steroid analysis in repeated sampling of peripartum baboons (Papio cynocephalus). Fecal samples were collected from 32 females in five groups within the Amboseli basin during 8 weeks prior to parturition and 13 weeks postpartum. From December 1999 through February 2002, 176 fecal samples were collected from individuals representing 39 peripartum periods. Fecal concentrations of progestins (fP), estrogen metabolites (fE), glucocorticoids (fGC), and testosterone metabolites (fT) were measured by radioimmunoassay. Steroid concentrations declined from late pregnancy to lactation, and the decline was greatest and most precipitous for fE and fP. Primiparous females had significantly higher mean fE concentrations in each of the last 2 months of pregnancy compared to multiparous females. Among multiparous females, fE and fT were significantly higher during late pregnancy in females carrying a male fetus compared to those carrying a female fetus. During early lactation, high fT in young mothers predicted subsequent infant death during the first year of life. These findings illustrate the potential power of repeated fecal-steroid sampling to elucidate mechanisms of life-history variability in natural populations. They also document significant differences in hormone profiles among subgroups, and highlight that such normative subgroup information is essential for interpreting individual variability in hormone-behavior associations.

Animals↗
PubMed2000

Reproductive stage and history affect the phonotactic preferences of female midwife toads, Alytes muletensis.

We investigated whether the reproductive stage or reproductive history of females affects their preferences for male calls that differ in frequency. We repeatedly tested gravid female midwife toads prior to and immediately after mating, and during ovulation. When females were ovulating they were much more consistent in their choice of call than when they were gravid but not ovulating. When females had recently mated they still showed positive phonotaxis, but did not reliably discriminate between alternative calls. This study is the first to test gravid female anurans repeatedly at different stages in their reproductive cycle (ovulating or not; pre- and postmating). It highlights the need to treat with caution the results from population-based preference studies in which individuals are tested only once, and in which variation in reproductive state is not taken into account. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2006

Reproductive risk factors for cutaneous melanoma in women: a case-control study.

Reproductive hormonal factors may have a potential role in cutaneous melanoma. This study estimated the risk of melanoma in women related to self-reported changes in nevi during pregnancy, while using oral contraceptives and/or hormone replacement therapy. Trained interviewers administered a questionnaire obtaining information about oral contraceptive use, hormone replacement therapy, reproductive history, sun exposure, occupation, and medical history from 318 Caucasian women newly diagnosed between 1991 and 1992 from two pigmented lesion clinics in San Francisco, California, and Philadelphia, Pennsylvania. A total of 395 frequency-matched control participants were recruited from hospital-affiliated outpatient clinics. Clinicians conducted skin examinations to assess the number and type of nevi, extent of freckling, solar damage, and skin type. For women aged less than 55 years, there was an association between a livebirth 5 years before diagnosis (odds ratio = 2.6, 95% confidence interval: 1.3, 5.3) and between number of births and melanoma risk (for > or = 3 births: odds ratio = 3.3, 95% confidence interval: 1.7, 6.5; ptrend < 0.001). Changes in nevi during recent pregnancies were a risk factor for melanoma, based upon small numbers (odds ratio = 2.9, 95% confidence interval: 1.1, 8.1). Oral contraceptive use and hormone replacement therapy were not associated with melanoma risk.

Adult↗
PubMed1989

Chronic disease among Seventh-day Adventists, a low-risk group. Rationale, methodology, and description of the population.

The Adventist Health Study is a prospective cohort study of 34,198 non-Hispanic white Seventh-day Adventists (13,857 men; 20,341 women, age 25-100 years) followed for 6 years (1977-1982). Within this population, 55.2% were lacto-ovovegetarian (consumed meat, poultry, or fish less than one time per week with no restrictions as to egg or dairy product consumption) in 1976 and most abstained from alcohol, tobacco, and pork products. Baseline data included demographic variables, information on current and past dietary habits, exercise patterns, use of prescription drugs, use of alcohol and tobacco, measures of religiosity, occupation and residential histories, anthropometric data, and menstrual and reproductive histories. Nonfatal case ascertainment was completed through review of self-reported hospitalizations obtained from annual self-administered mailed questionnaires and through computerized record linkage with two California population-based tumor registries. Fatal case ascertainment was completed via record linkage with computerized California state death certificate files, the National Death Index, and individual follow-up. During the 6 years of follow-up, 52.8% of the 34,198 study subjects reported at least one hospitalization. A total of 20,702 medical charts were reviewed for cancer and cardiovascular disease incidence and 1406 incident cancer cases and 2716 deaths from all causes were identified after baseline data collection.

Adult↗
PubMedDate not supplied

Pregnancy wastage in scheduled caste women of Punjab.

The present report is an attempt to secure adequate data about pregnancy wastage in scheduled caste women of Punjab who do not use any family limiting method. Analysis of reproductive histories of 922 Scheduled Caste women reveals that in the maternal age group 25-29 years, the mothers experienced the least number of abortions and still births. However, beyond this the risk of pregnancy wastage increases with age.

Abortion, Spontaneous↗
PubMed1998

How accurate is male recall of reproductive information?

The purpose of this study was to determine how well men recall reproductive information. By using a questionnaire, the authors surveyed men who had undergone orchiopexy for undescended testes and a group of matched control men, all of whom had had surgery at the Children's Hospital of Pittsburgh in Pittsburgh, Pennsylvania (n = 77), and their spouses. Subjects were a random subset of a larger (n = 1,212) male fertility study, which has been ongoing since 1992. In 1994, the spouses of men who participated in the study completed a short telephone survey that contained questions previously asked of their partners. Pearson correlations and kappa statistics were calculated to evaluate the accuracy of male recall of reproductive information. For the continuous measures, such as time to conception and frequency of intercourse, the correlations were high to moderate (r = 0.84 (p < 0.001) and r = 0.45 (p < 0.001), respectively). Agreement between the men and their spouses on the majority of bivariate (yes/no) questions, such as those concerning the use of birth control, as measured by the kappa statistic, was moderate to very good (K ranged from 0.14 to 0.69). Statistics were similar for formerly cryptorchid and control men. Male participants' responses to questions about their reproductive histories were accurate as compared with the responses given by their spouses. In this sample from a large cohort study, men appeared to recall reproductive information with acceptable accuracy.

Case-Control Studies↗
PubMed2002

Health-related behaviors and lifestyle factors of patients with breast cancer.

The purpose of this article is to examine differences in the relationship of selected lifestyle factors and health-related behaviors between two groups of women. The study used part of the data gathered in a national Jordanian case-control survey of 100 women with breast cancer and an equal sample of controls. Controls were selected to match the cases (patients) in terms of their age, education, and place of residence. The Health Belief Model and the basic Epidemiological Model were the theoretical framework used in this study. Data were collected using an interview form that was specifically constructed for the national survey. It contained 6 sections: demographics, history of cancer in the family, reproductive history, environmental factors, lifestyle factors, and health education about breast self-examination. The study revealed that there were no significant differences between the patients and controls with regard to their intake of fat, vegetable oil, beef and lamb meat, and smoked food. Higher proportions of patients were found to consume more of the canned and spicy food and caffeinated drinks. Neither smoking nor living or working with someone who smokes showed any significant differences between the patients and controls. Most of the women with breast cancer were found to have exercised in the last 5 years before diagnosis. Having been exposed to stressful events was a major significant risk factor discriminating patients from controls. Finally, having prior knowledge of breast self-examination was a health-related factor that made these women more attentive to their health.

Adult↗
PubMed1997

Factors associated with serum levels of estradiol and sex hormone-binding globulin among premenopausal Japanese women.

We measured serum levels of estradiol (E(2)) and sex hormone-binding globulin (SHBG) among 50 healthy premenopausal Japanese women in 1994 in Gifu, Japan, to investigate the relationships between potential risk factors for breast cancer and hormone levels. Using a self-administered questionnaire, we collected data on body size, physical activity, and previous disease history, as well as menstrual and reproductive histories of the woman and her mother. Blood samples were drawn from each subject on the 11th and 22nd days of her menstrual cycle. Higher serum E(2) levels were observed for women with shorter menstrual cycles. Age as well as cycle length were included in the regression models to determine the associations between hormone levels and study variables. Body mass index (BMI) was inversely related to SHBG level measured at the 11th day of the cycle, after adjusting for age and cycle length (r = -0.33; p = 0. 03). Women born in spring/summer had higher levels of E(2) on the 22nd day (p = 0.07) and higher levels of SHBG on both the 11th and 22nd days of the cycle (p = 0.01 and p = 0.06, respectively) than those born in other seasons. Physical activity at 13-15 years of age was inversely related to E(2) level on the 11th day of the cycle after controlling for age, cycle length, BMI, and birth month (r = -0.35; p = 0.04).

Adult↗
PubMed1991

Age structure and sex-biased mortality among Herero pastoralists.

Details of the population pyramid of living Herero and Mbanderu of Botswana suggest that infant and childhood mortality of males has been substantially greater than that of females. Direct tests from reproductive histories show that the hazard ratio is approximately 3 to 1 in favor of female survival in infancy and 2 to 1 in childhood. This biased mortality began in about 1960 in concert with recovery from infertility. A model of asymmetric fitness benefits between siblings is weakly supported. Logistic regression shows that heterogeneity among mothers explains much of the mortality of children under 2 years of age. A direct test for heterogeneity provides strong support for the hypothesis. Field methods appropriate for anthropologists are contrasted with those that are standard in demography. Finally, a contrast between these data and those from south Asia suggests that strong sex preferences may exist without being culturally articulated. Cultural norms do not necessarily coincide with behavior.

Age Factors↗