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PubMed1988

Season of birth of breast cancer patients and its relation to patients' reproductive history in Tokyo, Japan.

Seasonal distribution of the birth dates of 405 pre-menopausal and 285 post-menopausal breast cancer patients was investigated in order to determine whether or not the season of their birth was related to various reproductive risk factors of breast cancer, including nulliparity, late age at first birth, early age at menarche, late age at menopause, and a history of benign breast diseases. The seasonal distributions of births were compared between groups of patients categorized according to whether they possessed each risk factor or not, separately for pre- and post-menopausal patients. Patients with the same menopausal status generally had the same seasonal distribution of births, irrespective of whether or not they possessed a risk factor. Moreover, low-risk patients exhibited more deviation in the seasonal distribution of birth from general births than the high-risk patients. These results suggest that the distinctive seasonal distribution of birth observed in breast cancer patients is basically a phenomenon independent from the effect of the reproductive history on the occurrence of breast cancer, and that specific seasonal factors are involved at the fetal or neonatal stage in the etiology of breast cancer.

Adult↗
PubMed1999

Reexamining the link of early childbearing to marriage and to subsequent fertility.

Using data from the 1980, 1985, and 1990 Current Population Surveys, we show that the link between early fertility and nonmarital births has become stronger. Women who give birth earlier are increasingly likely to be unmarried. In contrast, we find a weaker association between first births at young (versus older) ages and (1) a rapid pace of subsequent childbearing and (2) higher completed fertility. We discuss possible causes and consequences of these changes.

Adolescent↗
PubMedDate not supplied

State variation in rates of cesarean and VBAC delivery: 1989 and 1993.

There is wide variation among states in rates of cesarean and vaginal births after cesarean (VBAC) deliveries. In general, states in the South have the highest cesarean rates, states in the West have the lowest, and states in the Northeast and Midwest are intermediate. Louisiana had the highest overall rate in 1993 (27.7 per 100 births) while Alaska had the lowest rate (15.2). The majority of states had declines in their cesarean rate between 1989 and 1993. Patterns in primary cesarean rates are similar to those of the overall rate-states in the South generally have the highest rates while states in the West have the lowest rates. Primary cesarean rates ranged between a high of 19.6 in Louisiana to a low of 10.6 in Wisconsin. In general, states with low cesarean rates have among the highest rates of VBAC delivery. Alaska had the highest VBAC rate (40.0), which was almost quadruple the rate of Louisiana (11.2), the state with the lowest rate. Most states had substantial increases in VBAC rates between 1989 and 1993. When examining cesarean rates by maternal age and birth order, states with the highest overall rates also have among the highest age/birth order-specific rates. Cesarean rates were lowest for mothers under 25 years of age having a second or higher order birth in Alaska, 10.4, and highest for mothers 35 years of age or over having a first birth in Mississippi, 51.3. Standardized cesarean rates which were adjusted for differences between states in maternal age and birth order distributions did not diminish the variation among areas.

Adolescent↗
PubMedDate not supplied

The influence of age at menarche on the fertility of Chinese women.

This paper examines the effect of age at menarche on children ever born (CEB). We use data from the 1997 Sample Survey of Population and Reproductive Health conducted by the China Population Information and Research Center and the State Family Planning Commission. Poisson regression models are estimated for 10,919 ever married Chinese Han women. The influence of a woman's age at menarche on her CEB is examined while controlling for the social effects of rural/urban residency, education, her number of fecund years, whether her first birth occurred before or after the initiation of China's one child policy, and her age at first marriage. The results support our hypothesized positive association between age at menarche and CEB. That is, the later a woman's age at menarche, the greater her number of children ever born. Holding the other five independent variables constant, we show that for every additional month in age at menarche, a Chinese Han woman's mean number of children ever born increases by 0.5 percent. Some of the implications of these results are explored.

Adolescent↗
PubMed2000

Premarital fertility in rural South Africa: a challenge to existing population policy.

The age pattern of fertility in a rural area of South Africa under demographic surveillance (Agincourt subdistrict) was investigated over the 1992-97 period. The total fertility rate (TFR) averaged 3.3 births per woman of reproductive age over the period, a major drop from earlier estimates in the same area (6.0 births in 1970-74). Age-specific fertility rates showed an atypical bimodal pattern. They were decomposed into two components of similar magnitude: premarital fertility (among women aged 12-26) and marital fertility (among women aged 15-49). The decomposition revealed the two underlying modes: a mode of premarital fertility (among women aged 18-20) and a mode of marital fertility (among women aged 28-30). Premarital fertility accounted for 21 percent of all births and for 47 percent of births among women aged 12-26. This pattern of high premarital fertility appears to reflect a low incidence of contraceptive use before the first birth, especially among adolescents, a low prevalence of abortion, and a high contraceptive prevalence thereafter. This finding calls for a reorientation of the family planning policy, which until now has targeted married women and women who have been pregnant once, but has failed to address the contraceptive needs of young women before their first pregnancy, especially adolescents.

Adolescent↗
PubMedDate not supplied

The pace of repeated childbearing among young American mothers.

Women who first give birth at ages 16 and younger are more likely to bear a second child within the next two years (26 percent) than are women who have their first child at ages 17-18 (20 percent) or at ages 19-22 (22 percent). However, there are important racial and ethnic differences in the likelihood of rapid repeated childbearing: Among whites, age at first birth has little effect on the proportions who have a second birth quickly; but among blacks, it has a significant inverse effect, with younger women more likely than older women to have a second child quickly. At nearly all ages at first birth, Hispanic mothers are more likely than either whites or blacks to have a second birth soon after the first. While the youngest black mothers (those 16 and under) are more likely than the youngest whites to have a rapid second birth, the oldest white mothers (those 19-22) are more likely than the oldest blacks. Socioeconomic background (represented by level of parental education), marital status at first birth and wantedness of the first birth also affect the pace of repeated childbearing. Compared with young mothers whose own mothers are high school graduates, those whose mothers are dropouts are more likely to have a second child within two years. Teenage mothers who are married at their first birth appear somewhat more likely than their unmarried counterparts to bear another child quickly; and mothers who wanted their first child at the time of conception are generally more likely to do so than are mothers whose first births were unwanted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Labor dystocia and its association with interpregnancy interval.

OBJECTIVE: The purpose of this study was to evaluate the prevalence of labor dystocia and its association with interpregnancy interval. STUDY DESIGN: We linked the birth data for Michigan infants who were born from 1994 to 2002 with the hospital discharge data. The International Classification of Diseases (9th revision, clinical modifications, ICD-9-CM) codes that indicate labor dystocia were identified by a physician panel and classified as functional and mechanical dystocia. We estimated the prevalence of labor dystocia and used stratified and logistic regression analyses to evaluate labor dystocia in relation to interpregnancy interval, controlling for other reproductive risk factors. RESULTS: Overall, 20.8% of the births involved labor dystocia (11.1% functional; 12.5% mechanical). Both functional and mechanical dystocia were more prevalent in first births than in subsequent births; mechanical dystocia was more prevalent in multiple births than in singleton births. In singleton births to multiparous mothers, labor dystocia was associated with the interpregnancy interval in a dose-response fashion. Compared with an interpregnancy interval of <2 years, the adjusted odds ratios that was associated with interpregnancy intervals of 2 to 3, 4 to 5, 6 to 7, 8 to 9, and 10+ years were 1.06 (95% CI, 1.04-1.08), 1.15 (95% CI, 1.12-1.17), 1.25 (95% CI, 1.21-1.29), 1.31 (95% CI, 1.26-1.37), and 1.50 (95% CI, 1.45-1.56), respectively, when we controlled for other reproductive risk factors. Functional dystocia was associated more strongly with interpregnancy interval than mechanical dystocia. CONCLUSION: Labor dystocia is common. In singleton births to multiparous mothers, labor dystocia increased with interpregnancy interval.

Adolescent↗
PubMed2005

Preterm birth in twins after subfertility treatment: population based cohort study.

OBJECTIVES: To assess gestational length and prevalence of preterm birth among medically and naturally conceived twins; to establish the role of zygosity and chorionicity in assessing gestational length in twins born after subfertility treatment. DESIGN: Population based cohort study. SETTING: Collaborative network of 19 maternity facilities in East Flanders, Belgium (East Flanders prospective twin survey). PARTICIPANTS: 4368 twin pairs born between 1976 and 2002, including 2915 spontaneous twin pairs, 710 twin pairs born after ovarian stimulation, and 743 twin pairs born after in vitro fertilisation or intracytoplasmic sperm injection. MAIN OUTCOME MEASURES: Gestational length and prevalence of preterm birth. RESULTS: Compared with naturally conceived twins, twins resulting from subfertility treatment had on average a slightly decreased gestational age at birth (mean difference 4.0 days, 95% confidence interval 2.7 to 5.2), corresponding to an odds ratio of 1.6 (1.4 to 1.8) for preterm birth, albeit confined to mild preterm birth (34-36 weeks). The adjusted odds ratios of preterm birth after subfertility treatment were 1.3 (1.1 to 1.5) when controlled for birth year, maternal age, and parity and 1.6 (1.3 to 1.8) with additional control for fetal sex, caesarean section, zygosity, and chorionicity. Although an increased risk of preterm birth was therefore seen among twins resulting from subfertility treatment, the risk was largely caused by a first birth effect among subfertile couples; conversely, the risk of prematurity was substantially levelled off by the protective effect of dizygotic twinning. CONCLUSIONS: Twins resulting from subfertility treatment have an increased risk of preterm birth, but the risk is limited to mild preterm birth, primarily by virtue of dizygotic twinning.

Birth Weight↗
PubMed2002

[The von Hippel-Lindau syndrome with pheochromocytoma].

The members of four generations of a family with Von Hippel-Lindau syndrome (VHL) have been followed by one of us (I.P.) for 30 years. The disease was proved in four members of this family, in three of them associated with pheochromocytoma. The grandmother (I-1) died at the age of 16 years two months after her first birth. The cause of death was not established. Her daughter (II-1) had 9 births with 5 children alive. Paresthesia and difficulties in walking followed by paraparesis and paraplegia were the first signs of the disease at the age of 58 years. The surgical treatment was performed because of an expansive lesion at the level of Th 3-4. Pathohistological examination was not done. It seems that a haemangioblastoma might be the cause of her disease. Diagnosis of pheochromocytoma was documented in a female patient (III-2) in 1972. Two years later she was successfully operated on. Pathohistological examination proved clinical diagnosis. She had also diabetes mellitus, cholelithiasis and cardiomyopathy. She died at the age of 56 years. A right-sided pheochromocytoma was diagnosed in a next female patient (III-4) at the age of 22 years. Her surgical treatment was successful. Retinal haemangioblastomatosis was established 7 years later in this patient. She was blind at the end of her life. Haemangioblastomatosis cerebelli was diagnosed soon, and she died at the age of 51 years. A 12- year old boy (IV-3) presented severe hypertension (36/24 kPa). Left-sided pheochromocytoma was removed in this patient one year later. Right-sided pheochromocytoma was operated on in the same patient at the age of 24 years. An elevated level of urinary dopamine was documented four years after the second operation. A malignant right-sided pheochromocytoma was operated on in the same patient 15 years later. At the same time metastases were found in the lower part of the right lung lobe. A 131-I-MIBG therapy could not be realized. He died at the age of 41. Pathohistological examinations proved the clinical diagnosis in this patient after all of three surgical treatments. MEN 2 syndrome was excluded by proper genetical analyses on the RET-protooncogen. Genetical analyses are in the course to identify the possible mutations of VHL-tumour-suppressor gene through the living members of the family. Multidisciplinary approach is mandatory in diagnosis, follow up and treatment of this specific group of patients. A collaboration among specialists of different fields of medicine (internal medicine, ophthalmology, neurology, radiology, urology, neurosurgery, biochemistry, pathology and genetics) is suggested.

Adolescent↗
PubMed2005

[Normal mice derived from oocytes following intracytoplasmic sperm injection (ICSI)].

This paper describes the use of piezo-driven micropipette for intracytoplasmic sperm injection of mice eggs. The head of fresh spermatozoa from KM (Kunming) fertile mice was individually injected into mature oocytes of hybrid mice B6D2F1. Approximately eighty three percent of sperm-injected oocytes survived, and 84.0% of them fertilized normally (extrusion of the second polar body and formation of male and female pronuclei). The eggs fertilized by sperm injection could develop in vitro to 2-cell (98% vs 94.7%), 4-cell (89.5% vs 92.1%) stages, no significantly (P > 0.05) different from embryos fertilized in vivo but there were significantly (P < 0.01) few morulae (63.8% vs 84.2%) and blastocysts (25.7% vs 68.4%) developed in vitro after further culture in vitro in the group of ICSI. When 120 embryos at the pronuclear stage were transferred to seven pseudopregnant KM female, 23.3% of the embryos (0 - 50%, depending on the host) reached the full term. Except for three that were cannibalized soon after birth, all of the young (25 pups) developed into normal and fertile adult. Here we report the first birth of mouse offspring following ICSI in China. These studies may increase understanding of the fertilization process and of how ICSI works.

Animals↗
PubMed2003

[Report of the first case in Poland of pregnancy after intrauterine insemination with semen of a HIV-1 seropositive partner and literature review].

HIV-1 serodiscordant couples are expressing increased interest in childbearing and many are seeking assisted reproduction. In 1992, Semprini et al. published a protocol for processing semen from HIV-1 seropositive men and reported the first births of healthy children after intrauterine insemination of the female partners with a fraction of motile spermatozoa. We described the first case in Poland of the intrauterine insemination of a female partner HIV(-) with the "washed" sperm of a 28-year old man infected with HIV. The woman gave birth to a healthy boy. Both mother and baby were tested for HIV-1 antibodies at the time of birth and 3 months later; both had negative results. Assisted reproduction techniques, although complicated and expensive are offered to serodiscordant couples as a preventive measure against infection that would result from unprotected intercourse.

Adult↗
PubMed2005

Size at birth and risk of breast cancer: prospective population-based study.

It has been hypothesized that birth size is positively associated with breast cancer risk in adulthood. We studied birth length, birth weight and head circumference at birth and subsequent risk for breast cancer in a cohort of 16,016 women in Norway. Birth length was positively associated with risk (p trend = 002), and women who were 53 cm or longer had a relative risk of 1.8 (CI = 1.2-2.6) compared with women who were shorter than 50 cm, after adjustment for birth year, length of gestation, birth order, maternal age, maternal marital status and socioeconomic status at childbearing. Mutual adjustment for birth weight did not influence the results, and further adjustment for maternal height and adult factors (age at first birth and parity) in a subset of the cohort did not change the results. For birth weight, women in the highest category (>/= 3,840 g) had an adjusted relative risk (RR) of 1.5 (CI = 1.0-2.2) compared to women in the lowest (< 3,040 g), but mutual adjustment for birth length attenuated this association (RR = 1.1; CI = 0.7-1.8). Head circumference at birth showed a similar association as birth weight, with attenuation after mutual adjustment for birth length. The positive association with birth length was stronger among women whose mothers were relatively tall (median or taller, p trend = 0.001) compared to women whose mothers were relatively short (below median, p trend = 0.67) at childbearing. The results provide evidence that intrauterine factors influence future breast cancer risk. The positive association related to birth length suggests that factors that stimulate intrauterine longitudinal growth are particularly important.

Aged↗
PubMed1986

Rhythm and conduction disturbances in isolated, congenitally corrected transposition of the great arteries.

The incidence and types of rhythm and conduction disturbances in 11 male and 6 female patients with congenitally corrected transposition of the great arteries and no other intrinsic complicating anomalies were studied. Patient age ranged from 5 to 54 years; follow-up ranged from 5 to 37 years. Surface electrocardiograms were recorded in each patient; 15 also underwent 24-hour Holter monitoring and 10 underwent electrophysiologic study. The conduction system of a 54-year-old woman who died suddenly, with complete atrioventricular (AV) block since age 30 years, was studied by serial histologic sections. Fifteen patients were asymptomatic and 2 reported repeated episodes of palpitation since childhood. Ten patients presented with a normal PR interval and 2 with first-degree AV block (12%). Five patients had complete AV block (29%), but none had had it at birth; first- and second-degree AV block preceded complete AV block in 2 patients. The morphologic pattern and duration of QRS suggested a junctional rhythm in 4 patients and an idioventricular pacemaker in 1 patient. Electrophysiologic studies confirmed that the complete AV block site was supra-Hisian in 2 patients and proximal to the His bundle bifurcation in 1 patient. However, histologic investigation disclosed fibrosis and disruption of the proximal nonbifurcating His bundle in the patient who died suddenly. In 2 patients with recurrent supraventricular tachycardia, electrophysiologic studies suggested reentry through James fibers (or dual AV nodal pathway) in 1 and the presence of a left lateral accessory AV pathway in the other. Holter monitoring showed a high incidence of ventricular arrhythmias.

Adolescent↗
PubMed1999

Ongoing pregnancy after intracytoplasmic injection of testicular spermatozoa into cryopreserved human oocytes.

Human oocyte cryopreservation has met with limited success in terms of both survival and subsequent fertilization. We recently reported the first birth of a healthy female infant after intracytoplasmic sperm injection of cryopreserved oocytes. The current report describes the first pregnancy achieved after intracytoplasmic injection of testicular sperm into cryopreserved human oocytes.

Adult↗
PubMed2004

Relationship between decreasing fertility during the post-war period and maternal age in a Japanese population.

This research was performed in an effort to understand the decrease in fertility that has occurred over the past few decades. The objective of the study was to analyze female fertility according to maternal age; data were based on the number of children born per mother. The records of 18-year-old college students were obtained, and the mothers of the students were categorized into age groups according to the year of their birth (1915 to 1949). The number of children born to each mother was then analyzed. The total sample size was 4078. The results showed that an increase in two-children families led to a reduction in the mean number of children per mother. While the decrease in the maternal age at the time of the birth of the last child in the family was observed, the maternal age at the time of the first birth did not increase. Thus, the reduction in fertility may not be the result of delayed motherhood. The group of mothers, who gave birth to the largest number of children, had their highest fertility rate in the twenties. In addition, their fertility rate in the thirties was almost equal to other groups, who had the same fertility level in their twenties.

Adolescent↗
PubMed1997

The interstitial gland of ovary of ewes from birth to sexual maturity.

The morphological and functional development of the interstitial gland was studied in crossbred ewe lambs (East Friesian x Black-Head Pleven breeds) first birth and then at 1, 2, 3, 4, 5, 5.5 and 6 months, as well as at 1 year in anestrous ewes. Histological and histochemical (AP, NAD.H2-tetrasole reductase, G-6-PDH and delta(5)-3 beta-hydroxysteroid dehydrogenase (delta(5)-3 beta-HSD)) methods and transmission electron microscopy (TEM) were applied while the FSH and LH levels were measured. There was an abundance of epithelial cell cords in newborn animals, while interstitial cells were scanty. Cortical and medullary epithelial cell cords occupied an essential place in the histogenesis of ovine ovarian structures. They were clearly expressed during the whole postnatal period of the development, and showed a species specificity. The development of the interstitial gland was correlated with changes in the gonadotropic hormones. A new population of interstitial glands appeared around puberty in a similar manner to the so-called 'puberty gland' in the testis and ovary of humans and other mammals. The results suggest that in these crossbred lambs, puberty was attained between the 3rd and 4th month, and sexual maturity and 5 to 6 months of age.

3-Hydroxysteroid Dehydrogenases↗
PubMed1997

Is fecundability associated with month of birth? An analysis of 19th and early 20th century family reconstitution data from The Netherlands.

The relationship between fecundability and month of birth was investigated in a cohort of 1526 women who married between 1802 and 1929, using only women whose first marriage occurred before the age of 35 years. On the basis of their time to pregnancy (TTP, calculated as time between wedding and first birth minus gestational length), women were categorized into two groups: fecunds (TTP up to 12 months or prenuptial conceptions, n = 1348) and subfecunds (TTP >18 months, n = 118). By use of logistic regression, cosinor functions with a period of 1 year or 6 months and variable shift and amplitude were fitted through the monthly odds of subfecunds versus fecunds. The best fitting curve was unimodal, with a zenith in September (P = 0.13 for H0: no differences). Exclusion of childless women (n = 36, minimum follow-up 5 years) from the subfecunds led to a similar curve (P < 0.01), while childless women, as compared with fecunds, showed a birth distribution that was best represented with a bimodal curve with zeniths in January and July (P = 0.06). This study provides evidence for the existence of differences in fecundability by month of birth. The cause of this relationship is unclear, but may lie in a melatonin-dependent circannual variability of the quality of the oocyte.

Female↗
PubMed2006

Maternal and biochemical predictors of spontaneous preterm birth among nulliparous women: a systematic analysis in relation to the degree of prematurity.

BACKGROUND: Nulliparous women are at increased risk of spontaneous preterm birth. Other maternal and biochemical risk factors have also been described. However, it is unclear whether these associations are strong enough to offer clinically useful prediction. It is also unclear whether the predictive power of these factors varies in relation to the degree of prematurity. METHODS: The risk of spontaneous preterm birth associated with maternal characteristics and second trimester serum screening data was analysed in a dataset of 84 391 first births in Scotland between 1992 and 2001 using Cox and logistic regression. Variation in the relative risk of preterm birth over the period 24-36 weeks was assessed using a test of the proportional hazards assumption. RESULTS: The risk of spontaneous preterm birth was positively associated with maternal serum levels of alpha-fetoprotein, socioeconomic deprivation, number of previous therapeutic abortions, smoking, and being unmarried and was negatively associated with height and body mass index. The risk of preterm birth at 24-28 weeks, but not later gestations, was increased in association with maternal levels of human chorionic gonadotrophin >95th percentile, maternal age <20, and two or more previous miscarriages. The area under the receiver operating characterise curve (95% CI) for models based on these factors was 0.67 (0.63-0.71) for 24-28 weeks, 0.65 (0.62-0.68) for 29-32 weeks, and 0.62 (0.61-0.63) for 33-36 weeks. CONCLUSIONS: Time to event analytic methods can identify factors that are differentially associated with spontaneous preterm birth according to the degree of prematurity. However, models based on maternal and biochemical data perform poorly as a screening test for any degree of spontaneous preterm birth.

Adult↗