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PubMed2000

Heritability and risk factors of uterine fibroids--the Finnish Twin Cohort study.

OBJECTIVES: Our aim was to study heritability, risk factors and hospitalization for uterine fibroids. METHODS: A random sample of 80 MZ and 80 DZ twins from the Finnish Twin Cohort were invited and 51% of the eligible women (n=82, 17 MZ and 16 DZ pairs, 40-47 years, mean age 43.0), underwent a transvaginal ultrasound. The entire cohort of 13872 women was linked to the national hospital discharge registry 1972-1990. RESULTS: Prevalence of fibroids was 66% and the average number of fibroids 1.7. The casewise concordance for being hospitalized for uterine fibroids was higher in MZ (0.31, 95% CI 0.24-0.37) than in DZ pairs (0.18, 95% CI 0.14-0.22). The proportion of variance in liability to fibroid hospitalization accounted for by genetic factors was 54.8% (95% CI 46.2-62.7%). Women with fibroids had higher body mass index (23.7 vs 21.7, P=0.0086), lower age at first birth (25.7 vs 29.3, P=0.012) and higher parity (3+ children 48.2 vs 29.6%, P=0.009) than women without fibroids. Risk ratio (RR) for fibroids in a MZ twin whose sister had been diagnosed with fibroids was 1.1 (95% CI 0.08;15), for a DZ twin 1.1 (95% CI 0.16;8.8) and for all twins 1.3 (95% CI 0.3; 6.1). Intraclass correlation for the number of fibroids was 0.24 for MZ and 0.11 for DZ twins, yielding an heritability estimate of 0.26. CONCLUSION: Reproductive and anthropometric factors may have at least as large role in pathogenesis of fibroids than genetic factors.

Adult↗
PubMed2003

Visual memory deficit in children with dysgraphia.

This study evaluates the performance of children with diagnosed dysgraphia and a control group on the Rey-Osterrieth Complex Figure test. A group of 48 Greek elementary school children aged 6.6 to 12.5 years who were in regular school placement participated. All had been diagnosed with dysgraphia, using the writing scale of the Luria-Nebraska Neuropsychological Battery and were matched with a control group of 48 for sex, age, grade, and handedness. Both groups were administered the test, and the children were examined during copying and mnemonic reproduction of the complex figure. Analysis indicated that there were no significant differences between dysgraphic and nondysgraphic groups during the copying task but the dysgraphic group performed significantly lower during mnemonic reproduction of the Rey-Osterrieth Complex Figure. These results suggest that children with dysgraphia possibly suffer from cognitive difficulties that influence visual memory more than visuomotor skills.

Agraphia↗
PubMed2001

[Risk of health disorders among women working with precision sterile technologies].

Results of hygienic, clinical, epidemiologic research helped to identify occupational risk factors for female workers engaged into microelectronic devices construction. The studies revealed occupational diseases and reproductive disorders in the females. The higher occupational risk was set for workers subjected to combined effects of complex low intensity factors, intensive work under exposure to chemical hazards.

Adult↗
PubMed1998

Exacerbation of premenstrual asthma caused by an oral contraceptive.

BACKGROUND: The relationship between sex hormones and asthma has not been clarified. Studies have suggested a potential beneficial effect of exogenous sex hormones and/or contraceptive pills on asthma in premenopausal females whereas the data for postmenopausal females are inconsistent. CASE REPORT: A 33-year-old woman suffering from asthma with premenstrual exacerbations had a stable course until she began taking oral contraceptives. At that time she experienced clinical deterioration of her asthma associated with decline of pulmonary function tests. No other precipitating factors were identified. After discontinuing the contraceptives, her condition returned to baseline. CONCLUSION: We found only two reports of worsening of asthma related to hormonal therapy (estrogen in one case, contraceptive pills in the other) in premenopausal women. Our report, together with these observations, suggests that in some premenopausal women exogenous sex hormones and/or contraceptive pills may, contrary to expected, produce exacerbation of asthma.

Adult↗
PubMed1994

Age at natural menopause and sociodemographic status in Finland.

Differences in age at natural menopause by occupation, education, and place of residence were examined using a cross-sectional population sample of Finnish women aged 45-64 years (n = 1,713, response rate 86%). The sample was selected at random from the Finnish Population Register in 1989 (final n = 1,505, 75%). Kaplan-Meier estimates showed the median age at natural menopause to be 51 years for all women (95% confidence interval (CI) 50.6-51.4). The median menopausal age of smokers and nulliparous women was 50 years; that of nonsmokers and women whose first full-term pregnancy occurred before the age of 25 years was 52 years. Differences between occupational and educational groups were statistically significant (Mantel-Cox test for occupation, p < 0.02; for education, p < 0.03). In the Cox proportional hazards model, the odds ratio of the occurrence of natural menopause among upper white-collar women was 0.74 (95% CI 0.57-0.96) and among the most educated women (education > 11 years) it was 0.75 (95% CI 0.59-0.96), adjusted to reflect smoking, use of hormones, body mass index, and age at first full-term pregnancy. Sociodemographic variables appear to be associated with age at natural menopause in a representative sample of Finnish women.

Age Factors↗
PubMed2003

Assortive mating for personaltiy traits, educational level, religious affiliation, height, weight, adn body mass index in parents of Korean twin sample.

The degree of assortative mating for psychological and physical traits in Asian societies in relatively unknown. The present study examined assortative mating for educational level, personality traits, religious affiliation, height, weight, and body mass index in a korean sample. Age-adjusted spouse correlations were high for educational level (r = .63) and religious affiliation (r = .67), modest for most personality traits (rs = -.01 to .26), and trivial for height (r = .04), weight (r = .05)m and body mass index (r = .11). These results were remarkably similar to those found from the western samples. Implications of the present findings in behavior genetic studies and human mating patterns were briefly discussed.

Adult↗
PubMed2002

Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial.

BACKGROUND: Recent studies have suggested that periodontal disease is a risk factor for preterm low birth weight (PLBW). A randomized controlled trial was undertaken to help further evaluate the proposed association between periodontal disease and PLBW. METHODS: Four hundred pregnant women with periodontal disease, aged 18 to 35, were enrolled while receiving prenatal care in Santiago, Chile. Women were randomly assigned to either an experimental group (n = 200), which received periodontal treatment before 28 weeks of gestation or to a control group (n = 200) which received periodontal treatment after delivery. Previous and current pregnancies and known risk factors were obtained from patient medical records and interviews. The primary outcome assessed was the delivery at less than 37 weeks of gestation or an infant weighing less than 2,500 g. RESULTS: Of the 400 women enrolled, 49 were excluded from the analyses for different reasons. The incidence of PLBW in the treatment group was 1.84% (3/163) and in the control group was 10.11% (19/188), (odds ratio [OR] 5.49, 95% confidence interval [CI] 1.65 to 18.22, P= 0.001). Multivariate logistic regression analysis showed that periodontal disease was the strongest factor related to PLBW (OR 4.70, 95% CI 1.29 to 17.13). Other factors significantly associated with such deliveries were: previous PLBW (OR 3.98, 95% CI 1.11 to 14.21), less than 6 prenatal visits (OR 3.70, 95% Cl 1.46 to 9.38), and maternal low weight gain (OR 3.42, 95% CI 1.16 to 10.03). CONCLUSIONS: Periodontal disease appears to be an independent risk factor for PLBW. Periodontal therapy significantly reduces the rates of PLBW in this population of women with periodontal disease.

Adolescent↗
PubMedDate not supplied

Menstrual patterns after female sterilization: variables predicting change.

Previous studies of the changes in menstrual pattern characteristics following sterilization have been flawed by methodologic errors. As a result, contradictory findings have been reported. Appropriate methodologic approaches to the study of poststerilization menstrual patterns are presented, and a new methodologic approach-an index of menstrual pattern change-is offered, which evaluates four menstrual parameters simultaneously. A carefully controlled study using this index indicates that most women report no change in menstrual pattern at 12 months poststerilization, and among those who do experience change, changes in one direction are balanced by changes in the other direction. The changes reported include improvements as well as changes for the worse. The best predictor of whether a woman would experience menstrual pattern change after sterilization is whether her pattern had any abnormal characteristics during the three months prior to the procedure. Surgical variables and special subgroups of women are also evaluated.

Adult↗
PubMed1995

Transforming growth factor-beta 1 mediates communication between human endometrial carcinoma cells and stromal cells.

The role of transforming growth factor-beta 1 (TGF-beta 1) in communication between human endometrial carcinoma (EC) cells and normal endometrial stromal cells (NSC) was investigated using a cell culture model. Serum-free conditioned medium (CMe) from EC cells (RL95-2, HEC1A) inhibited the proliferation (cells per colony < 50% of control; mitotic index 25-50% of control) of NSC. In contrast, NSC-conditioned medium (CMn) stimulated the proliferation of EC cells, but inhibited the growth of NSC. The proliferation of EC cells was stimulated by the range of dilutions of CMe which inhibited the proliferation of NSC. Using confocal microscopy and a monoclonal antibody, TGF-beta 1, a known product of differentiation in the female reproductive tract, was localized to the cytoplasm of NSC and EC cells. Using a protein slot-blot chemiluminescence method, secreted TGF-beta 1 was detected in serum-free medium conditioned by the growth of NSC and EC cells. TGF-beta 1 antibody-neutralized CMe or CMn stimulated the proliferation of both NSC and EC cells. This study suggests that endometrial carcinoma-stromal cell interactions involve autocrine-paracrine signaling pathways, and that TGF-beta 1 protein is one mediator of such interactions.

Autopsy↗
PubMed2004

Role of utero-ovarian vascular impedance: predictor of ongoing pregnancy in an IVF-embryo transfer programme.

The objective of this study was to evaluate the role of uterine, endometrial and follicular blood flow in prediction of ongoing pregnancy after assisted conception. A prospective observational study was conducted on 53 women undergoing IVF treatment. Transvaginal colour and pulsed Doppler measurements were performed on the day that pituitary suppression was confirmed, on day 10 of ovarian stimulation and on the day prior to human chorionic gonadotrophin injection. On the last day of ovarian stimulation, blood flow in the ascending uterine artery of the women who would conceive was characterized by significantly lower pulsatility index values. Sub-endometrial vascular impedance was comparable in the pregnant and non-pregnant groups. There were no differences in the perifollicular vascularity between pregnant and non-pregnant women. The chance of achieving pregnancy predicted by uterine artery Doppler and perifollicular blood flow in women whose PI values were higher than 3.26 and 1.08 was very low, with a sensitivity of 1.00 and specificity of 0.59 and 0.82 respectively. The data provide evidence for an association between utero-ovarian perfusion and reproductive outcome following IVF treatment. Uterine and ovarian vascular impedance values identify those women whose pregnancy chances are significantly limited. Measures to decrease vascular impedance in such women might enhance pregnancy rates by improving embryo quality and uterine receptivity for implantation.

Embryo Transfer↗
PubMed2003

Women empowerment and marital fertility in Oman.

International studies have the inverse relationship of women education and empowerment on fertility. Our aim is to study the association of women education and empowerment with some of fertility indicators or determinants namely; total number of children ever-born, age of women at her first birth and the last closed birth interval length in a community based survey (National Health Survey, 2000) A cross-sectional survey of the health status of Omani community was designed. Face to face interview to 2037 ever married women including demographic data, fertility patterns, family planning, two women empowerment indices (decision making and freedom of movement), and other reproductive health modules. About 31% of the sample was considered highly empowered in decision- making and the mean number of decisions taken in the household was 4.46 for the overall sample. For freedom of movement, 29% of the sample was highly empowered with a mean number of 3.88 for the overall sample. The mean values of both indices varied significantly according to age, residence, level of education and work status. Higher freedom of movement score women was more likely to have less number of children in the first 20 years of marriage. Women of 'higher score of decision making index were more likely to have longer closed birth interval. Those scored low in the decision making index were more likely to get a child at an earlier age. In developing countries where fertility limitation depend on "modern" methods, women's education and autonomy are considered as strong tools to make changes in demographic transition.

Adolescent↗
PubMed1991

Very early pregnancy wastage in in vitro fertilization and embryo transfer (IVF-ET).

The occurrence and incidence of early pregnancy wastage in an in vitro fertilization and embryo transfer (IVF-ET) program have been studied in 750 patients. In 297 (39.6%) a pregnancy was diagnosed; of these, 14.8% were biochemical and 24.8% clinical pregnancies. In the latter group 23.6% aborted, while 75.8% had clinical ongoing pregnancies. The mean embryo quality score of the biochemical pregnancy group was similar to that of the clinical ongoing pregnancy group but statistically different from that of the clinical abortion group (P less than 0.005). Furthermore, the clinical ongoing pregnancy rate in women with previous biochemical pregnancy was 24.7%, a significantly higher percentage compared to clinical ongoing pregnancies achieved in IVF-ET cycles (P less than 0.05). It is possible that biochemical pregnancy does not represent an index for infertility but rather an intact stage of reproduction leading toward implantation. The high clinical pregnancy rate in subsequent cycles may probably serve as an encouraging sign or a marker for future clinical pregnancy.

Abortion, Incomplete↗
PubMed2004

Gonadotropin response to clomiphene and plasma leptin levels in weight recovered but amenorrhoeic patients with anorexia nervosa.

Anorexia nervosa (AN) is a state of leptin and gonadotropin deficiency. Leptin levels are decreased in normal weight women with hypothalamic amenorrhea and leptin may be a sensitive marker of overall nutritional status. The aim of the study is to provide additional information on plasma leptin levels and on gonadotropin responses after clomiphene testing in patients with AN who recovered weight but were still amenorrheic. We evaluated 17 patients with AN, female age 20+/-1.2 yr who reached goal weight [body mass index (BMI) 14.9+/-0.5 to 19.3+/-0.4 kg/m2]. At diagnosis serum leptin levels were 2.2+/-0.1 microg/l while after behavioural therapy and hypercaloric diet for 6-12 months serum leptin levels rose to 6.4+/-1.4 microg/l significantly lower compared with those in the control (no.=10, age 28+/-6.2 yr, BMI 21.1+/-0.3 kg/m2, leptin 9.3+/-0.7 pg/l; p<0.05). None of the patients resumed spontaneous menstrual cycles after weight gain. They were tested with a 10-day administration of clomiphene citrate. All had a significant rise in LH secretion (from 1.7+/-0.3 IU/l to 8.3+/-0.9 IU/l, p<0.01) and serum estradiol levels (from 19.0+/-5.4 to 937.7+/-241.2 pg/ml, p<0.03). Nine out of 17 patients menstruated after clomiphene. Serum leptin levels were not different in those who menstruated from those who did not (6.4+/-1.4 to 6.8+/-1.4 microg/l, p>0.05). Body compositon was studied in 12 additional carefully matched patients with AN who recovered weight. Six of them resumed spontaneous menstrual cycles. Neither BMI, body fat, nor leptin appeared as significant determinants of menstrual status. In conclusion, relative hypoleptinemia persists, independent of fat mass, in weight recovered patients with AN. A normal response to clomiphene in weight-recovered yet still amenorrhoeic patients with AN, offers reassurance that the axis is intact and that the problem lies in the hypothalamus. It is reasonable to believe that nutritional disturbances, fat intake and persisting psychological factors still affect plasma leptin levels and reproductive functions in weight-recovered patients with amenorrhea.

Adolescent↗
PubMed2003

Weight variation in a cohort of women using copper IUD for contraception.

The objective of this study was to assess weight changes over time in reproductive-age women using nonhormonal contraception [copper intrauterine device (IUD) users]. Baseline variables recorded included age, parity, decade when the IUD was inserted and the presence of hypertension. A total of 1697 IUD users were followed for 7 years of use. The mean age (+/- SD) of the women at the beginning of follow-up was 27.6 +/- 5.8 years and the mean height (+/- SD) was 150 +/- 10 cm. The mean weight (+/- SD) at the time of IUD insertion was 58.5 +/- 0.30 kg. After 5 and 7 years of follow-up, the mean weight (+/- SD) was 61.2 +/- 0.33 kg and 62.4 +/- 0.51 kg, respectively. At insertion, the body mass index mean (+/- SD) was 24.5 +/- 0.12 and after 3 years it was 25 +/- 0.14, remaining above 25 up to the 7th year of observation. During the 7 years of follow-up, older women gained more weight than younger women. Parity, decade of IUD insertion and hypertension were not noted to be significant determinants of weight variation. In conclusion, this cohort of lower and middle class Brazilian copper IUD users tended to gain weight during their reproductive life, independent of other factors. These observations may improve counseling of women regarding the prevention of age-related obesity.

Adult↗
PubMed1998

Women of reproductive age with endometriosis are not osteopenic.

OBJECTIVE: To determine whether women of reproductive age with endometriosis are osteopenic and whether bone density decreases with higher stages of endometriosis. DESIGN: A multicenter cross-sectional study was performed. SETTING: Thirty-nine gynecological clinics in the United States, Canada, and Puerto Rico. PATIENT(S): Two hundred forty-one women of reproductive age with laparoscopically proved endometriosis. INTERVENTION(S): Diagnostic laparoscopy, bone densitometry. MAIN OUTCOME MEASURE(S): Endometriosis stages according to the criteria of the American Society for Reproductive Medicine, lumbar spine bone mineral density (L2-L4) as measured by dual-energy x-ray absorptiometry. RESULT(S): The mean lumbar spine bone mineral density, as well as the distribution of bone mineral density, of the women with endometriosis was similar to that of a normal population. There were no significant differences between endometriosis stage groups I-IV regarding bone mineral density as well as body weight, body mass index, and height. CONCLUSION(S): Women of reproductive age with endometriosis are not osteopenic. More advanced stages of endometriosis are not associated with a decrease in lumbar spine bone mineral density.

Adolescent↗
PubMed2004

Progress in chemoprevention of breast cancer.

Primary prevention trials have shown that tamoxifen lowers breast cancer incidence by 30-40%. Because of the endometrial risk of tamoxifen and the pro-thrombotic effects of tamoxifen and raloxifene, different strategies are being pursued to improve the risk:benefit ratio of breast cancer chemoprevention. Thus, raloxifene is being compared with tamoxifen in a phase III trial, while the minimal active dose of tamoxifen is being assessed in phase I-II trials. Also, the combination of hormone replacement therapy (HRT) and tamoxifen may reduce the risks while retaining the benefits of either agent. Anastrozole holds promise as a preventive agent based on preliminary results on contralateral breast cancer. The identification of women at increased risk for estrogen receptor (ER)-positive breast cancer due to hormonal and reproductive factors may maximize the therapeutic index of hormonal agents. Finally, new targets that interfere with ER-negative breast carcinogenesis are being sought as one-third of breast cancers will not be preventable by hormonal interventions.

Aromatase Inhibitors↗
PubMed2002

Influence of mild infections on iron status parameters in women of reproductive age.

OBJECTIVE: To investigate the effects of mild infections on iron status parameters. DESIGN: A prospective observational study. SETTING: A population of female nurse students in Norway. SUBJECTS: 33 women with self-reported episodes of infection and 33 women without infections but with comparable s-ferritin at baseline. MAIN OUTCOME MEASURES: Change from baseline in haemoglobin, s-iron, TIBC, transferrin saturation, s-ferritin, e-protoporphyrin and s-transferrin receptor on days 3, 7, 14, 21, 28 and 56 after onset of illness, compared to changes in non-infected subjects tested in parallel. RESULTS: In febrile illness, such as influenza, there was a significant rise in s-ferritin that could take more than a month to normalise. S-ferritin increased significantly when CRP rose above 20 mg/L, but a normal CRP could not preclude falsely high s-ferritin values due to infection. S-iron and transferrin saturation fell below normal range in a substantial proportion of cases in the symptomatic stage, even in infections without a febrile response, such as the common cold, but was normalised within a week after onset of infection. CONCLUSION: For more than a month after febrile illness such as influenza, s-ferritin is not a reliable measure for ruling out iron deficiency in women of reproductive age.

Adult↗
PubMed1991

Nutritional epidemiology of postmenopausal breast cancer in western New York.

The authors studied 439 postmenopausal breast cancer cases, identified in hospitals throughout western New York, with an interview schedule that considered frequency and amount ingested of 172 foods and provided data for an estimate of total calories ingested. These were compared with age-matched controls comprising a random sample of the same communities as the cases. The extensive interviews, requiring 2.0 hours on average to administer, also covered alcohol ingestion, Quetelet index, and a wide variety of reproductive factors. The authors found, as have most investigators over the past 25 years, that risk increased with increases in age at first pregnancy, decreased with increases in numbers of children and pregnancies, and increased in those with history of benign breast disease and in those with female relatives previously affected with breast cancer. Risk adjusted for potential confounders was highest among women with the lowest ingestion of carotene or a substance correlated with its ingestion. Risk was not associated with retinol ingestion. It increased with increases in Quetelet index. Fat intake, whether studied in terms of quantity or the proportion of total calories derived from fat, was not associated with risk of breast cancer. Our analyses of these factors were adjusted for age, education, and the reproductive history traits described above.

Adult↗