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PubMed1986

Evidence for a protective effect of lactation on risk of breast cancer in young women. Results from a case-control study.

Female residents of King County, Washington state, aged 25-54 years, in whom breast cancer was diagnosed in 1981 and 1982 were interviewed regarding their reproductive histories. Their responses were compared with the responses of a sample of women from the same population, who were selected by random digit-dialing from the same county, so that their age distribution resembled that of the cases. Premenopausal women who had ever lactated had 0.49 times the risk of developing breast cancer, as compared to premenopausal women who had never lactated (95% confidence interval, 0.30-0.82). Among both premenopausal and postmenopausal women, risk of breast cancer decreased with increasing duration of lifetime lactation experience, although the effect was consistently stronger for premenopausal women. This protective effect persisted after adjustment for age, parity, and age at first full-term pregnancy. Other reproductive factors, and demographic factors such as income and education, did not confound the relationship. This study confirms other recent findings of a protective effect of lactation against the development of breast cancer in young women.

Adult↗
PubMed1989

Is early natural menopause a biologic marker of health and aging?

The relation between age at natural menopause and all-cause mortality was investigated in a sample of 5,287 White women, ages 55 to 100 years, naturally-postmenopausal, Seventh-day Adventists who had completed mailed questionnaires in 1976. The age-adjusted odds ratio of death during 1976-82 in women with natural menopause before age 40 was 1.95 (95% confidence interval = 1.24, 3.07), compared to the reference group of women reporting natural menopause at ages 50 to 54. Corresponding odds ratios of death were 1.39 (95% CI = 1.06, 1.81) for natural menopause at ages 40 to 44, and 1.03 (95% CI = 0.84, 1.25) for natural menopause at ages 45 to 49. Among 3,166 White, 55- to 100-year-old, surgically-postmenopausal, Adventist women, there was no relation between age at surgical menopause and mortality. Logistic regression analyses indicated that findings from this study were apparently not due to confounding by smoking, over- or underweight, reproductive history, or replacement estrogen use.

Adult↗
PubMed2002

The role of prisons in the HIV epidemic among female injecting drug users.

The objective of this study was to describe factors associated with imprisonment of female injecting drug users (IDUs) and to assess if female IDUs who have been in prison have different HIV risk behaviours when compared to females IDUs who have never been incarcerated. A seroepidemiological survey was conducted of 304 female IDUs recruited in outreach and treatment programmes in Madrid, Spain. Data on sociodemographic characteristics and recent and lifetime risk factors, sexual and reproductive history and history of imprisonment were collected. Bivariate analysis and a logistic regression model were used to identify factors associated with imprisonment. Risk factors for imprisonment were having illegal sources of income, not having a fixed address, leaving education before finishing primary school and starting injection of drugs early in adolescence. HIV risk behaviours were highly prevalent among this population of female IDUs and drug injection in prison was reported by more than one-third of those who had ever been imprisoned. In addition, recent HIV risk behaviour indicators were not associated with imprisonment, suggesting that incarceration did not lead to risk reduction after release from prison. Female IDUs who have been in prison have substantial reproductive health problems that require gynaecological care. These results point to the urgent need for prevention programmes which address HIV and other blood-borne infections using gender specific approaches for women IDUs incarcerated in Spanish prisons.

Adult↗
PubMed1989

Reduced fecundability in women with prenatal exposure to cigarette smoking.

Animal studies have suggested that fertility may be impaired by transplacental exposures, but little is known about human prenatal exposures and subsequent adult reproduction. A possible relation between prenatal exposure to cigarette smoking and adult fecundability in women was explored, with the use of data from a prospective study of 221 North Carolina couples. These couples were recruited during 1983-1985, at the time they stopped using birth control in order to become pregnant. The relative fecundability of exposed compared with unexposed women was estimated by applying a discrete-time proportional probabilities model to the cycle-by-cycle conception rates. Women with prenatal exposure to their mother's cigarette smoking had reduced fecundability. The fecundability ratio associated with prenatal exposure to mother's smoking, adjusted for age, frequency of intercourse, current smoking status, age at menarche, and childhood exposure to cigarette smoking, was 0.5 (95% confidence interval 0.4-0.8). This association was not changed by further adjustment for other possible confounding variables, including educational level, reproductive history, body weight, and consumption of alcohol and caffeine. Thus, women whose mothers smoked while pregnant with them may be on average substantially less fecund than women whose mothers did not smoke during pregnancy.

Adult↗
PubMedDate not supplied

Fibroids, infertility and pregnancy wastage.

Uterine fibroids are often found in women of reproductive age. Different types of fibroids may affect reproductive outcome to a different extent, with submucous, intramural and subserosal fibroids being (in decreasing order of importance) a cause of infertility and pregnancy wastage. Fibroids may also produce a number of complications during pregnancy. Women who are scheduled for assisted conception should be advised to have submucous and possibly intramural fibroids removed prior to IVF. Large fibroids (>5 cm), wherever their location, should be considered individually, with the reproductive history being an important consideration. Miscarriage rates are significantly reduced following myomectomy. Open myomectomy should be the route of choice when there are large subserosal or intramural fibroids, multiple fibroids or entry into the uterine cavity is to be expected. Proper assessment of the benefits and risks of surgery for individual patients should be carefully considered before offering a procedure.

Abortion, Spontaneous↗
PubMed1984

Impact of PKU on the reproductive patterns in collaborative study families.

Factors that relate to reproductive patterns in 129 families after the birth of a child with phenylketonuria (PKU) include birth order of the index child, age of the parents at the birth of the index child, and expressed intentions of the parents whether or not to have additional children. Factors that do not correlate with reproductive histories include knowledge of the genetic and metabolic nature of PKU, the relationship of PKU to mental retardation and special diet, parental upset about the diagnosis, sex of the affected child, parental IQ, religion, education, and social class. Correlations found related to the question, "Is PKU the reason you don't want more children?" include stress factors in family functioning, mother's upset with the diagnosis, father's concerns about being a carrier, sex of the child with PKU, and degree of knowledge about PKU. Many of the Collaborative Study clinics tend to be more concerned about the consequences of PKU on the family than on society, and feel that families should receive genetic counseling to determine their reproductive risks and future plans. Upon self-report, many clinics declare their counseling to be either "completely nondirective" or making a "conscious effort to be nondirective."

Birth Order↗
PubMed1981

Relationship of body weight to menarcheal and menopausal age: implications for breast cancer risk.

Early menarche and late menopause are risk factors for the development of breast cancer. An adequate hormonal mechanism for those observations has not been described. Because obesity has also been associated with increased breast cancer risk, we examined the relationship among height, weight, adiposity, and menstrual cycle characteristics in women who prospectively recorded menstrual cycle intervals and reproductive events as part of the Menstrual and Reproductive History Research Program. Within this study cohort, adult height, weight, and a derived index of adiposity were related to both earlier age at menarche and later age at menopause. The association of early age at menarche with adiposity persisted from age 18 yr through middle age and into the menopausal years. There was no relationship between body mass and age at first pregnancy, another breast cancer risk factor. Women who were heavier at 18 yr of age and thereafter gained 5 lb or more had significantly greater mean menstrual cycle length and variability during the 7-yr period after menarche than the other members of the cohort. There was no obvious relationship between weight indices and menstrual cycle pattern during mature reproductive life or during the 7 yr before menopause. Our data suggest that menarcheal and menopausal age may have a common relationship to nutritional status and to constitutional features that predate the onset of menarche and persist into later life.

Adipose Tissue↗
PubMed1998

Suboptimal zinc status in pregnant Malawian women: its association with low intakes of poorly available zinc, frequent reproductive cycling, and malaria.

A study of 152 rural Malawian women aged 23.2+/-5.5 y (x+/-SD) at 24 wk gestation included measurements of biochemical indexes of zinc (plasma and hair), protein (serum albumin), and infection (serum C-reactive protein, white blood cell count, and malaria), and dietary intakes (via three interactive 24-h dietary recalls). Data on health, demographic and socioeconomic status, family characteristics, reproductive history, and anthropometry were also collected. The study revealed a high prevalence of suboptimal zinc status: 36% of the women had low plasma and 46% had low hair zinc values. Median daily intake of zinc (9.0 mg) was low and poorly available: 61% was provided by cereals and 20% by flesh foods. Median intake of animal protein was only 5.6 g/d, and phytate intakes were high (1.4 g/d). Women consuming diets with phytate-zinc ratios > 17 (the median) had lower hair zinc concentrations (1.6 compared with 1.8 micromol/g, P < 0.03), were older (24 compared with 20 y, P < 0.02), and had a higher number of pregnancies (3 compared with 2, P < 0.02) than those consuming diets with a phytate-zinc ratio < 17. Frequent reproductive cycling was related to zinc status; hair zinc was higher for a prima- than for a multigravida (2.0 compared with 1.6 micromol/g, P < 0.01). Malaria prevalence was also associated with hair zinc (P < 0.05) but not with plasma zinc, after the number of pregnancies was controlled for. We conclude that low intakes of poorly available dietary zinc, frequent reproductive cycling, and malaria prevalence are three major factors in the etiology of suboptimal zinc status in these rural, pregnant Malawian women.

Adolescent↗
PubMed1980

Impaired reproductive performance in DES-exposed women.

The reproductive history of 69 women with demonstrated diethylstilbestrol (DES)-related cervical-vaginal abnormalities is reviewed. All of the patients were sexually active non-contraceptive users who were studied over an 8-year period. Forty-six patients conceived, for an uncorrected fertility rate of 66.7%. Fourteen patients elected therapeutic abortion. The 32 remaining patients had 62 pregnancies which resulted in 26 living children, for a success rate of 41.9%. However, cervical cerclage was required for continuation of 8 of these successful pregnancies. The 36 pregnancy failures consisted of 19 first- and 11 second-trimester spontaneous abortions, 3 third-trimester losses due to permaturity, and 3 tubal pregnancies. Uterine abnormalities were found in all of the 25 patients who underwent hysterosalpingograms. Although other reproductive diseases unrelated to DES exposure in utero were also present in this select group of patients, it is probable that the high rate of infertility and pregnancy wastage is related to the uterine structural abnormalities encountered.

Abortion, Spontaneous↗
PubMed1978

Oral contraceptive use: association with frequency of hospitalization and chronic disease risk indicators.

A questionnaire was mailed to 97,364 married women, aged 26--50, resident in Greater Boston in 1970, requesting information on lifetime oral contraceptive (OC) use, reproductive history, education, and hospitalization experience in 1969; 65,843 women responded. In 1973 a second questionnaire was mailed to 37,292 of these women, including all OC users and an equal number of non-users matched on age, parity, education, and town of residence. This questionnaire related to use of OCs, other female hormones, and the menopause. OC use was most strongly related to age, with a sixfold increase in use from the oldest women (of whom 10 per cent had used OCs at some time) to the youngest. Use was directly related to education and mobility and inversely related to parity. Reasons for beginning and ceasing use differed for women of different ages and educational attainment. Thus, use of OCs varies with social and reproductive characteristics that are risk indicators for many diseases. OC use was associated with increased risk of hospitalization for thromboembolic disease (risk ratio = 1.5, 95 per cent confidence limits 1.2, 3.2) and for mental illness, hyperthyroidism, hypertension, and cancer of the cervix. OC users were hospitalized for many non-life threatening conditions 20 to 40 per cent more frequently than were non-users.

Adult↗
PubMed2003

Reproductive performance of crossbred dairy cows in different production systems in the Central Highlands of Ethiopia.

The study was conducted to examine the fertility status of crossbred dairy cows in mixed crop-livestock production (MCLP), market-oriented specialized dairy production (MSDP) and urban dairy production (UDP) systems, including the Holetta Agricultural Research Center (HARC). Data on general farm management variables and reproductive histories were collected from study farms by questionnaire and from individual cow records. Age at first service and age at first calving were 29.58 months (n = 424) and 40.6 months (n = 348), respectively. Cows managed under UDP were younger at first service and at first calving (p<0.05). The mean intervals from calving to first service and to conception were 141.98 days (n = 284) and 185.02 days (n = 219), respectively. The mean calving interval for cows was 551.82 days (n = 258). Cows in MCLP had longer intervals from calving to first service and to conception and longer calving intervals than those managed under MSDP, UDP and HARC. First service conception rate (43.42%), number of services per conception (1.75) and pregnancy rate (79.29%) did not differ significantly between production systems. Reproductive performance was best in UDP followed by HARC and MSDP. The difference between MCLP and the rest points to particular difficulties in that system. To improve reproductive performance and economic benefit, there should be conservative stocking rate, sensible year-round feeding, a herd health plan, and sustainable extension service.

Animals↗
PubMed2000

Correlated response in reproductive and life history traits to selection on testis length in Drosophila hydei.

Flies in the genus Drosophila have undergone striking evolutionary divergence in the size and number of sperm produced. Based on comparative studies of sperm length, testis length, and other reproductive and life history traits, including body size, age at first reproduction, and the number of sperm produced, macroevolutionary trade-offs resulting from the need to produce high-investment testes have been postulated. To understand better the microevolutionary processes underlying these interspecific patterns, we imposed replicated bidirectional selection for testis length for 11-12 generations on D. hydei, a species with 23.5 mm-long sperm and 30 mm-long testes. Testis length exhibited realized heritabilities ranging from 0.45 to 0.72. Following selection, traits were assayed for correlated responses. Thorax length, testis mass, sperm length, egg-to-adult development time, and posteclosion maturation time showed consistent positive correlated responses. Numbers of sperm produced and transferred to females, male longevity, female egg productivity, and seminal receptacle length did not show consistent correlated responses to selection on testis length. The pattern of correlated responses to testis length reveal the potential for the evolution of reproductive strategies to alter important life history attributes.

Animals↗
PubMed1990

Epidemiology and natural history of breast cancer. Implications for the body weight-breast cancer controversy.

The mechanisms of differentiation of the mammary gland apparently can explain the contradictory findings on the association of breast cancer with excess body weight. Excess weight may be related to the initiation of breast cancer in premenopausal women through its effect on menstrual cycles and on progesterone secretion and to the promotion of breast cancer in postmenopausal women through its effect on estrogen metabolism. Although body weight is unlikely to be as strong a risk factor for breast cancer as it is for endometrial cancer, it may have a greater importance from a public health point of view, because the ratio of the incidence of breast cancer to that of endometrial cancer is 4.5 in whites and 6 in blacks. Thus, more studies seem warranted. It is not possible, however, to rule out the view that the reported correlation between excess weight and breast cancer is attributable to failure to adjust for potential confounders, such as dietary fat. New insights may come from the combined assessment of weight, different types of dietary fat, and reproductive history factors known to be involved in the natural history of breast cancer. For example, in the Women's Intervention Nutrition Study (WINS), the survival rate of breast cancer patients on a 20 per cent fat diet is being compared with that of breast cancer patients of similar weight keeping their usual 35 to 40 per cent fat diet. This investigation will show whether dietary fat influences the rate of progression (metastasis) and of promotion (occurrence of cancer in the other breast) independent of body weight.

Body Weight↗
PubMed1998

Ovarian growth and folliculogenesis in breeding and nonbreeding females of a social rodent, the Zambian common mole-rat, Cryptomys sp.

Zambian common mole-rats are subterranean rodents that live in families with only one female breeding. Her offspring remain in the parental nest and do not reproduce. Behavioral experiments (Burda, '95) demonstrated that their apparent "sterility" is based on incest avoidance and individual recognition of family members. To elucidate whether some kind of morphologically apparent ovarian suppression still takes place in daughters, ovaries of females of known age, weight, and reproductive histories were examined histologically and morphometrically. The body mass of old females (more than 3 years of age) begins to decrease, and the ovaries seem to begin to atrophy at the age of about 3-6 years. Ovaries in neonates exhibited primordial and primary follicles, sometimes clustered in nests. Ovaries of adult nonbreeding females expressed all stages of the follicular development up to tertiary follicles. Many unruptured luteinized follicles were present, but true corpora lutea as a morphological sign of ovulation were missing. Unruptured luteinized follicles also could be found (additionally to true corpora lutea) in ovaries of breeding females. The number of primordial follicles dropped rapidly during the first 2 years of age; the number of primary, secondary, and tertiary follicles was subject to individual variation; and there was no clear correlation with age or reproductive status. While a tendency to form accessory unruptured luteinized follicles may just reflect taxonomic affinities of bathyergids to hystricomorphs, the otherwise complete folliculogenesis in "sterile" daughters and the presence of unruptured luteinized follicles even in breeding females are further evidence that there is no hormonal suppression of the ovarial cycle. We suggest that ovulation in nonbreeding females is not actively suppressed by the breeding female, but instead that it is not released because the triggering mechanisms, most probably repeated copulation, are missing.

Age Factors↗
PubMed2001

Contraceptive use and family planning after labor in the European part of the Russian Federation: 2-year monitoring.

OBJECTIVES: To explore the main determinants of the reproductive behavior of nursing mothers, all inhabitants of the central part of the European region of the Russian Federation, their use of modern contraceptive methods and their attitude to future family planning. METHODS: Open cohort multicenter study of 1200 nursing mothers aged 16-42 years interviewed at 3-5 days' postpartum, with subsequent longitudinal monitoring ofthe majority in the local family planning centers during the 2 years after labor. RESULTS: The main determinants of the reproductive behavior of this cohort of women are an early debut of sexual activity, several partners in their reproductive history, relatively early marriage with a motivation to have one child in their family and the tendency to use induced abortion as one of the methods of birth regulation. Our experience of postpartum counselling demonstrated positive changes in the women's attitudes to modern contraceptive methods. The data reveal that the induced abortion rate among 639 mothers regularly followed-up during the first year postpartum was 4.4%, and among 606 during the second year was 5.1%. The corresponding rates among 129 women who did not visit the family planning centers and who were only interviewed 2 years after labor were 9.3% and 8.5%, respectively. CONCLUSIONS: Our data show that the unmet needs are remarkably concentrated among women who have given birth within the last year or two, and who need augmented attention from the family planning and reproductive health services.

Abortion, Induced↗
PubMed1992

Prenatal care in primary health care centers of Al Hassa, Saudi Arabia.

The objective of this study was to determine the performance of Al Hassa primary health care (PHC) centers in the scope of prenatal care and to have a baseline data for future evaluation of achievement in that field. A retrospective study was done by collecting information on a pre-designed form from the available records in the PHC centers. The number of registered pregnant ladies for prenatal care in PHC centers was 10,594 which was equal to 58% of the estimated number of pregnant ladies in Al-Hassa, in 1409 H (the official calendar of Saudi Arabia corresponding to 1989). The immunization coverage by tetanus toxoid of the registered pregnant ladies was 66.7% for the first dose and 40.3% for the second dose. Forty six percent of the registered pregnancies was identified by PHC staff as high risk pregnancy. It was found that 64.4% of the high risk pregnancy was due to causes in the reproductive history, 25.4% due to associated medical conditions and 7.2% due to causes in the present pregnancy. A self criticism and future need to improve prenatal services are discussed.

Adult↗
PubMed1995

Reproduction and sera embryotoxicity after immunization of monkeys with the laminin peptides YIGSR, RGD, and IKVAV.

Monkeys with excellent reproductive histories were immunized with the laminin peptides YIGSR, RGD, IKVAV, and YD, a control sequence with no known biological function. Sera from the YIGSR-immunized monkey became toxic, causing neural tube defects in whole rat embryo cultures, and this monkey experienced fetal loss after immunization. Sera from the RGD-immunized monkey also became embryotoxic in culture after immunization, but this monkey appeared to become infertile as she failed to initiate a pregnancy for at least 2 years after immunization. In contrast, embryos cultured on sera from the IKVAV- or YD-immunized monkeys were predominantly normal and both monkeys completed successful pregnancies. Antibody levels to the respective peptides or to laminin were not predictive of embryotoxicity, but antibody binding to homogenized yolk sacs as well as to yolk sacs of cultured embryos was associated with sera embryotoxicity and reproductive outcomes in vivo. These observations suggested that the laminin sequences YIGSR and RGD may play a role in immune-mediated reproductive failure by reacting directly with embryonic tissue and could provide a basis for identifying individuals at risk for both spontaneous abortion and infertility.

Amino Acid Sequence↗
PubMed2004

[Women who are partners of a man infected by HIV: description of their characteristics and appraisal of risk].

OBJECTIVE: To describe the situations of risk and the prevalence of HIV in women with a heterosexual partner infected by HIV. DESIGN: Cross-sectional descriptive study. SETTING: Out-patient HIV diagnosis centre in Madrid. PATIENTS: 229 women seen for the first time between 1993 and 2002 because they had a stable heterosexual partner diagnosed with HIV, and who were exposed to no other risk. MAIN MEASUREMENTS: Social and personal details, reproduction history, sexual conduct, clinical, and analytic data of both partners. RESULTS: 66% of couples had maintained sexual relations for over a year. Women were on average younger (29.6 years old) than the men. 29% of the women had children and 5.2% were pregnant. 82% of men had injected drugs, but only 13% still did. 73% had been diagnosed with HIV for over 6 months, 16% had AIDS criteria, and 35% were taking retroviral treatment. 60% of the men who knew of their infection had systematically avoided sex without condoms, against 33% of those who did not know they were infected (P<.001). 19% had had accidents in use of the condom. HIV seroprevalence in the women was 6.1% (95% CI, 3.5%-10.3%). CONCLUSIONS: Health care of people with HIV must include care of their sexual partner, involving information, psychological support, preventive and reproductive advice, as well as diagnosis of HIV or other sexually transmitted diseases.

Adult↗