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At least 613 records · Page 34Linked to original sources
PubMed1998

Risk factors for contralateral breast cancer in Chennai (Madras), India.

BACKGROUND: This is the first cohort study conducted in India to identify risk factors for contralateral breast cancer (CBC) among patients with first primary breast cancer. METHODS: Patients with first primary breast cancer diagnosed in 1960-1989 at the Cancer Institute (WIA) in Chennai, India, were followed-up until 31 December 1994. The risk of CBC was assessed among unilateral breast cancer (UBC) patients who survived for >12 months following the diagnosis of breast cancer and did not develop a second cancer (n = 2665) and among those who developed a CBC > or =12 months after the diagnosis of breast cancer (n = 39). RESULTS: The age-adjusted incidence of CBC among women with UBC was seven times the incidence (per single breast) in the general population. Among women with UBC the relative risk (RR) was 4.5 (95% CI: 1.1-19.6) comparing those with and without a history of breast cancer in the mother, and 2.8 (95% CI: 1.2-6.7) comparing age at first birth 21-25 versus earlier. The RR was 0.3 (95% CI: 0.1-0.6) comparing those with and without hormone therapy for their UBC. Radiotherapy for the UBC had no significant effect on the incidence of CBC. CONCLUSION: Positive family history of breast cancer and later age at first childbirth emerged as stronger risk factors for CBC than UBC. Hormone therapy reduces the risk of CBC.

Adult↗
PubMed1990

Labor market segmentation and relative black/white teenage birth rates.

"Teenage mothers typically have lower educational attainment than other women. Most observers have argued that this is a major reason for their greater risk of poverty. This article takes the opposite view: that circumstances associated with poverty contribute to a greater likelihood of teenage childbearing. In particular, poor educational quality and the chances of secondary sector employment are more common for black women, regardless of their age at first birth. Hence the payoffs to education may be quite low for these women, which may be the reason for early motherhood. This argument is presented in terms of segmented labor market theory. Data to support it is presented from the [U.S.] National Longitudinal Survey of Youth. Other common explanations of teenage motherhood are critiqued."

Black or African American↗
PubMed1992

Reproductive factors in breast cancer epidemiology.

There is abundant epidemiologic evidence showing that early menarche, late menopause, low parity and late age at first birth are related to increased risk of breast cancer. However, in younger age groups, uniparous women seem to be at higher risk than nulliparous, and the effect of later pregnancies is less clear in this group. Intervals between pregnancies may modify the general protective effect. Some studies have indicated an adverse effect of late age at pregnancies after the first. Further studies are necessary to determine if the general protective effect of pregnancies after the first is preceded by a transient increase in breast cancer risk. No clear association has been established with number of abortions. Results from two large prospective studies suggest that breast feeding is not strongly related to risk of breast cancer among Western populations.

Abortion, Induced↗
PubMed1992

Reproductive factors and the risk of hepatocellular carcinoma in women.

The relationship between reproductive factors and the risk of primary liver cancer was analyzed using data of a case-control study conducted in Northern Italy between 1984 and 1991 on 79 women with histologically or serologically confirmed hepatocellular carcinoma and 344 controls in hospital for a wide spectrum of acute, non-neoplastic diseases. The multivariate relative risk (RR) for parous vs. nulliparous women was 2.6 (95% confidence interval (CI) 1.2 to 5.8), and the risk increased with parity from 2.1 for 1, to 2.6 for 2, to 3.2 for 3, to 3.5 for 4 or more births (chi 2(1) trend = 6.49, p = 0.01). The relative risks were above unity, though not significantly, in women reporting spontaneous (RR = 1.3) and induced (RR = 1.6) abortions, and there was a significant trend in risk with total number of abortions. An apparent inverse trend in risk with age and first birth was accounted for by parity. No relationship emerged with age at menarche, at menopause or other menstrual factors. The association between parity and hepatocellular carcinoma was, if anything, more marked at older ages, since the RR was 1.6 (95% CI 0.5 to 4.6) below age 60, and 4.8 (95% CI 1.3 to 18.1) at age 60 or over. This observation has relevant public-health implications, since in developed countries primary liver cancer is extremely rare among young women, but not at older ages. The association between parity and hepatocellular carcinoma is similar to that described for combined oral contraceptives, again confirming that the impact of contraceptives on the risk of several neoplasms is similar to that of pregnancy.

Adult↗
PubMed2004

A prospective study of induced abortion and breast cancer in African-American women.

OBJECTIVE: There continues to be controversy about whether induced abortion influences the risk of breast cancer. Because case-control studies of this relation are subject to recall bias, there is a need for prospective data. Further, there has been little study of abortion and breast cancer in African-American women. We assessed the relation of abortion to risk of breast cancer in a prospective follow-up study of African-American women. METHODS: Black Women's Health Study participants have been followed by mailed questionnaires every two years since enrollment in 1995. Participants reported 348 incident breast cancers during 205,983 person-years of follow-up. Women who had an induced abortion were compared with women who had never had one, with nulliparous and parous women analyzed separately. Incidence rate ratios (IRR) with two-sided 95% confidence intervals (CI) were derived from Cox regression models that controlled for age, age at first birth, number of births, history of spontaneous abortion, and other factors. RESULTS: Among nulliparous women, the IRR for any induced abortion relative to none was 0.9 (95% CI = 0.5-1.4), and among parous women, the comparable IRR was 1.1 (95% CI = 0.8-1.4). Risk did not vary by number of abortions, age at first abortion, age at diagnosis or a family history of breast cancer in either nulliparous or parous women. CONCLUSIONS: Our findings indicate that induced abortion does not increase breast cancer risk in African-American women.

Abortion, Induced↗
PubMed1984

Age at menarche and subsequent reproductive events.

A woman's age at menarche may be related to later reproductive performance, including age at first birth and risk of spontaneous abortion. This paper presents data from 2062 women with 4477 pregnancies in the Menstrual and Reproductive Health Study, a prospective study which has been in progress since 1935. Age at menarche is directly related to the age at which a woman marries and conceive a first child, but is unrelated to total fertility, frequency of induced abortion, or risk of stillbirth. Women with either early or late menarche are significantly more likely to have had an ectopic pregnancy. Overall spontaneous abortion risk declines slightly with increasing age at menarche. This trend is not seen, however, when first pregnancies alone are considered. This suggests that the overall trend with age at menarche is not related to a woman's underlying spontaneous abortion risk but rather to unknown selective factors. Women who were very young (less than 11 years) at menarche differ from the others with regard to many measures of reproductive performance. However, these women represent only a small proportion of the total study group.

Abortion, Spontaneous↗
PubMed1991

Increasing incidence of coeliac disease in Sweden.

Changes in the incidence of coelic disease was studied among children born in Göteborg, Sweden, between 1970 and 1988. A total of 188 patients with coeliac disease were found. Of these, 83% were less than 2 years old at the time of their first duodenal biopsy and 74% of them have so far been verified according to the criteria of the European Society for Gastroenterology and Nutrition (ESPGAN). The cumulative incidence at 2 years of age/1000 liveborn infants increased significantly from 0.31 in the first birth cohort to 2.93 in the last. This increase could only partly be explained by improvements in detection. Weight for age at diagnosis was generally considerably below the reference value, but was slightly less affected towards the end of the period. The increase in incidence of coeliac disease is the first reported since the middle 1970s and makes the disease one of the most common chronic diseases among Swedish children.

Age Factors↗
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↗
PubMed1988

Epidemiologic characteristics of women with uterine fibroids: a case-control study.

Risk factors for uterine fibroids were analyzed in a hospital-based case-control study conducted in the greater Milan area, based on 275 women with histologically confirmed fibroids and 722 controls with acute nongynecologic or hormone-related conditions. Questions were asked about menstrual and reproductive characteristics, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. The risk of uterine fibroids was reduced in parous women relative to nulliparous ones (relative risk 0.6) and in those who were postmenopausal (relative risk 0.1 compared with premenopausal women of the same age). Women with fibroids tended to have an earlier age at menarche and at the last birth, to be more educated, and to use intrauterine devices and oral contraceptives more frequently, although these findings were not statistically significant. Current smoking (but not past smoking) lowered the fibroid risk by about 40%. No associations were found with body mass index, history of spontaneous or induced abortions, and age at first birth.

Adult↗
PubMed2003

Reconstructing life history of hominids and humans.

Aspects of life history, such as processes and timing of development, age at maturation, and life span are consistently associated with one another across the animal kingdom. Species that develop rapidly tend to mature and reproduce early, have many offspring, and exhibit shorter life spans (r-selection) than those that develop slowly, have extended periods of premature growth, mature later in life, reproduce later and less frequently, have few offspring and/or single births, and exhibit extended life spans (K-selection). In general, primates are among the most K-selected of species. A suite of highly derived life history traits characterizes humans. Among these are physically immature neonates, slowed somatic development both in utero and post-natally, late attainment of reproductive maturity and first birth, and extended post-mature survival. Exactly when, why, and through what types of evolutionary interactions this suite arose is currently the subject of much conjecture and debate. Humankind's biocultural adaptations have helped to structure human life history evolution in unique ways not seen in other animal species. Among all species, life history traits may respond rapidly to alterations in selective pressures through hormonal processes. Selective pressures on life history likely varied widely among hominids and humans over their evolutionary history. This suggests that current patterns of human growth, development, maturation, reproduction, and post-mature survival may be of recent genesis, rather then long-standing adaptations. Thus, life history patterns observed among contemporary human and chimpanzee populations may provide little insight to those that existed earlier in hominid/human evolution.

Adaptation, Physiological↗
PubMed2001

Occupational exposures and cancers of the endometrium and cervix uteri in Finland.

BACKGROUND: Endometrial cancer incidence rates are low in Asia and Africa and high in North America and Northern Europe. Cervical cancer is often the most common female cancer in developing countries, and infection with human papillomavirus (HPV) is its main risk factor. However, other factors, such as occupational exposures may modify the HPV-related risk. We conducted an exploratory register-linkage study in Finland to assess the role of occupational exposures on incidence rates of cancers of the endometrium and cervix uteri. METHODS: Occupational risk factors for endometrial and cervical cancers were explored in a 25-year follow-up of female workers born 1906-1945 (N = 413,877) identified through the Population Census of Finland of 1970. Job titles in census records were converted to exposures of 31 occupational agents through a job-exposure matrix. Poisson regression models estimated relative risks (RR) for each agent, standardized for birth cohort, follow-up period, and socio-economic status. For each agent, the product of level and probability of exposure was calculated and subdivided in three categories: zero, low, and medium/high. Adjustment at the job title level was done for the turnover rate (endometrial and cervical cancers), mean parity, and age at first birth (endometrial cancer). RESULTS: Endometrial cancer (2,833 cases) was associated with exposure to animal dust (RR 1.2, low level, 174 cases) and sedentary work (RR 1.3, high level, 145 cases). Cervical cancer (1,101 cases) was associated with exposure to aliphatic and alicyclic (RR 1.3, low level, 91 cases), aromatic (RR 1.2, low level, 318 cases; RR 1.4, high level, 41 cases), and chlorinated hydrocarbon solvents (RR 1.3, low level, 50 cases), silica dust (RR 1.2, low level, 251 cases), and wood dust (RR 1.2, low level, 249 cases). CONCLUSIONS: This study suggests that occupational exposures may be associated with increased risk of endometrial and cervical cancers.

Adult↗
PubMed1980

Oestrogen receptors in breast tumours: associations with age, menopausal status and epidemiological and clinical features in 735 patients.

Comparisons between oestrogen-receptor (RE)-positive or negative patients were made on a continuous series of 735 patients with primary breast tumours seen at the major treatment centre in British Columbia between 1975 and 1978. RE positivity was commoner in older patients, and was not associated with menopausal status independently of age. The concentration of receptor protein also increased with increasing age, but was not affected by menopausal status. Neither RE status nor quantity was associated with any of the epidemiological risk factors studied, which included parity, age at first birth, weight, family history and exposure to oestrogenic drugs and oral contraceptives. Patients with RE- tumours were more likely to present with symptoms other than a breast lump, pain or nipple inversion, and had less-differentiated tumours; they did not differ from RE+ patients in terms of stage, size of tumour, or interval from first symptom. These findings are discussed in terms of the biological origin and determinants of oestrogen receptors.

Adult↗
PubMed1999

Unique checkpoints during the first cell cycle of fertilization after intracytoplasmic sperm injection in rhesus monkeys.

Intracytoplasmic sperm injection has begun an era of considerable improvements in treating male infertility. Despite its success, questions remain about the dangers of transmitting traits responsible for male infertility, sex and autosomal chromosome aberrations and possible mental, physical and reproductive abnormalities. We report here the first births of rhesus monkeys produced by intracytoplasmic sperm injection at rates greater or equal to those reported by clinics. Essential assumptions about this process are flawed, as shown by results with the preclinical, nonhuman primate model and with clinically discarded specimens. Dynamic imaging demonstrated the variable position of the second meiotic spindle in relation to the first polar body; consequently, microinjection targeting is imprecise and potentially lethal. Intracytoplasmic sperm injection resulted in abnormal sperm decondensation, with the unusual retention of vesicle-associated membrane protein and the perinuclear theca, and the exclusion of the nuclear mitotic apparatus from the decondensing sperm nuclear apex. Male pronuclear remodeling in the injected oocytes was required before replication of either parental genome, indicating a unique G1-to-S transition checkpoint during zygotic interphase (the first cell cycle). These irregularities indicate that the intracytoplasmic sperm injection itself might lead to the observed increased chromosome anomalies.

Animals↗
PubMed1985

Epidemiology of breast cancer in a Mexican-American population.

This is a historical cohort study of breast cancer mortality in the Mexican-American community of Laredo, Texas. Included in this study were virtually all breast cancer deaths recorded in Laredo since 1875; controls matched to cases by age and birth year were drawn from the total population. Fertility history and family history of disease for cases and controls were retrieved from the genealogical data base reconstructed by our group from church and civil records for the whole city of Laredo. The findings of this study show an association between breast cancer risk and age at first birth. This study confirms familial risk to be a factor in breast cancer risk. Unlike postmenopausal breast cancer mortality in the total U.S. population, which has increased only slightly in the last 30-40 years, postmenopausal breast cancer death rates in Laredo have almost tripled since the 1940's.

Adult↗
PubMed2006

Determinants of adolescent pregnancy in an urban area in Turkey: a population-based case-control study.

The aim of this study was to determine the degree to which socioeconomic status is a risk factor for first birth at age 19 or younger in married women in an urban area of Turkey. The research was a population-based case-control study. The study group comprised all married and pregnant women aged 15-19 (adolescent pregnancies) attending primary care centres (144 subjects). Married women between 20 and 29 years of age, experiencing their first pregnancy (adult pregnancies), were determined as the control group (144 subjects). A questionnaire was completed for each subject during face-to-face interviews. Adolescent pregnancy was more frequent in women from families with a low socioeconomic status, as determined by occupation (class) and income; both were associated with adolescent pregnancy. Multiple logistic regression analysis identified seven factors associated with adolescent pregnancy: exposure to violence within the family prior to marriage; families partially opposed or unopposed to adolescent marriage; secondary school or lower education level; lack of social security; living in houses in which the number of persons per room was over 1; unemployed women; and having sisters with a history of adolescent pregnancy.

Adolescent↗
PubMed1993

Determinants of pregnancy outcomes and targeting of maternal health services in Jamaica.

Detailed nationally representative population level data were used to investigate the pre-natal care and delivery experiences of pregnant women in Jamaica. The results of this study show that: (a) demographic criteria (particularly first births) and self-reported clinical pregnancy complications are valid predictors of deleterious maternal health outcomes and can be used to stratify mothers into risk groups. (b) There appears to be a significant problem of under and inappropriate utilization of pre-natal care services by all women and in particular by demographically 'high risk' women, i.e. young, first time mothers. Significant proportions of the latter group report either no pre-natal care visits at all or visits which are later than the first trimester. The problems of delayed initiation of pre-natal care are specially exacerbated for poor, teenage mothers who happen to be living in the Kingston Metropolitan Area. (c) In terms of the content and quality of pre-natal care services the message is somewhat mixed. On the positive side the pre-natal care system is doing a moderately satisfactory job with regard to diagnostic tests and educational advice. On the negative side however, the fact that once women enter the health care system they all receive the same moderately adequate care (in terms of diagnostic evaluations and educational advice) with no attempt to focus particular attention on high risk mothers is troublesome. (d) With regard to appropriate delivery venues for pregnant women, pre-natal care visits do not appear to significantly influence the choice of delivery venues. Moreover, rich urban women are much more likely to deliver in a hospital than their rural peers. In conclusion, the study discusses the social and behavioral context of these results, addresses the policy implications and makes some recommendations to improve maternal health services.

Adult↗
PubMed2002

Maternal and perinatal outcome in nulliparous women aged 35 and older.

OBJECTIVE: To compare the maternal and perinatal outcome of nulliparous women 35 years and older at the time of delivery with nulliparous women 25-29 years old. METHODS: A retrospective review of maternal and newborn records of singleton gestations only for first birth in women aged 35 and older (study group n = 143) were compared with pregnancies of women aged 25-29 (control group, n = 148) delivered at the same period with respect to pregnancy complications and outcome. The study was performed at the Princess Badeea Teaching Hospital in North Jordan between January 1, 1996 and July 1, 2000. RESULTS: Most of the elderly nulliparous women were professionals (60%) and 20% had a history of infertility. Compared with women aged 20-29 years, women delivering their first child at or >35 years were at increased risk of weight gain, obesity, chronic and pregnancy-induced hypertension, antepartum haemorrhage, multiple gestation, malpresentation, and premature rupture of membranes. Women aged 35 years and older were also substantially more likely to have preterm labour, oxytocin use, and caesarean births. The older women differed significantly in neonatal outcomes: gestational age, birth weight, preterm delivery, low birth weight, small for gestational age, fetal distress and neonatal intensive care unit admissions. CONCLUSION: It is concluded that nulliparous women 35 years and older had higher risk of antepartum, intrapartum, and neonatal complications than nulliparous women aged 25-29 years, but these risks, for the most part, are manageable in the context of modern obstetrics. The excess rate of caesarean sections is only partially accounted for by gestational complications. Despite the increased risk of complications, perinatal death of the study group was similar to that of the control group. There were no maternal deaths.

Adult↗