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PubMed1975

Retrospective and prospective epidemiological studies of 1500 karyotyped spontaneous human abortions.

Epidemiologic studies, retrospective and prospective, were done on 1500 abortions collected from 1966-1972. No secular or seasonal variations were observed. From the analysis of the relative frequencies of the different types of chromsome anomalies it is estimated that 1 out of every 2 conceptions has a chromosome anomaly. Maternal-age influence was found only for the autosomal trisomy group, mainly D and G trisomies. No effect of oral contraceptives were discovered. An increased frequency of chromosome anomalies occurred after ovulation-inducing therapy and after occupational exposure of the father to irradiation. No variations in the fertility rate and in the frequency of congenital malformations in births following abortions was noted. The incidence of recurring abortion was mainly influenced by the reproductive history of the couple before the karyotyped abortion.

Abortion, Spontaneous↗
PubMed1980

Maternal hormone therapy and congenital heart disease.

Exogenous female sex hormone exposure was studied in the mothers of 110 infants with conotruncal malformations of the heart, born in the years 1972-75. Cases were ascertained throughout the referral area of the Maryland State Intensive Care Neonatal Program. For each case, three normal controls were chosen from the birth population: Two matched on eight characteristics related to the likelihood of hormone-taking (race, maternal age, parity, fetal losses, gestational age, delivery mode, time of prenatal registration, private/service), and one also on the infant's sex and birthweight; the third control was chosen at random. In personal interviews, information was obtained on the mother's general health, family history, reproductive characteristics, pregnancy health, and environmental exposures. Identification of hormonal products was aided by a display of pills and packages. Maternal recall was examined in comparison to the responses of a group of mothers of infants with hypoplastic left heart ("disease controls"). Regression analysis on time elapsed since the infant's birth revealed no difference in recall between the mothers of cases and of controls. Multilogistic regression analysis, controlling for confounding variables and for scores constructed for reproductive, malformation, and exposure risks, showed no increase in relative risk for cases when compared with matched controls. When compared to random controls, the analysis suggested a possible increase in relative risk with increased environmental exposure scores; components of the risk score were excess smoking and alcohol intake, exposure to X-ray, drugs, paints, insecticides, and chemicals. The possible significance of this finding needs to be further investigated.

Abortion, Threatened↗
PubMed1999

Relation of Lake Ontario fish consumption, lifetime lactation, and parity to breast milk polychlorobiphenyl and pesticide concentrations.

Lactating female members and spouses of male members of the New York State Angler Cohort who agreed to provide breast milk samples were the subjects of this study. Questionnaires were provided to participants focusing on Lake Ontario fish consumption, reproductive history, and lactation history. Milk samples were analyzed for 77 polychlorinated biphenyls (PCB) congeners, 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (DDE), a metabolite of dichlorodiphenyltrichloroethane (DDT), hexachlorobenzene (HCB), and 1,1a,2,2,3,3a, 4,5,5,5a,5b,6-dodecachlorooctahydro-1,3, 4-methano-1H-cyclobuta[cd]pentalene (Mirex). The percentage of samples with quantifiable levels, above the limit of detection (LOD), varied among the individual congeners from 10 to 100%. Nine PCB congeners (designated by their IUPAC No.) and DDE were found in all of the 100 samples analyzed. These include the following, in decreasing order of concentration: DDE>153>138>180>118>187>188>177>200. Total PCB concentrations were estimated by taking the sum of the concentrations of all PCB congeners (up to 77 congeners) above their respective LOD in a given sample. PCB concentrations increased with increasing concentration of milk lipid. Lipid adjusted PCB concentrations increased as a function of maternal age. PCB congener profiles in milk favored the higher chlorinated congeners, with the four highest congeners having 5 to 7 chlorine atoms. Fish eaters had a significantly higher level of several major PCB congeners with congeners 153 and 138 being 1.36 and 1.34 times higher, respectively. PCB and DDE concentrations, expressed on a lipid basis, varied inversely with parity. The total number of months of lifetime lactation varied inversely with the total PCB concentration in breast milk. A similar relationship was evident for DDE. These data are of use for risk assessment in estimating the relative exposure to these environmental contaminants in breast fed infants whose mothers consumed contaminated Lake Ontario fish.

Adult↗
PubMed1999

Intrauterine lead exposure and preterm birth.

The objective of this study was to determine the risk of preterm birth in relation to umbilical cord blood lead levels (UCL) among primiparous and multiparous women. A case-cohort study was performed in Mexico City during 1995. A total of 459 full-term births was compared with 161 preterm births (before 37 gestational weeks). Mothers were interviewed before the delivery about their reproductive histories and other related factors of preterm birth. Lead was determined by atomic absorption spectrophotometry. Lead levels were higher in primiparous women who had a preterm birth than in primiparous women with a full-term birth (9.77+/-2.0 microgram/dl vs 8.24+/-2.15 microgram/dl); this difference was marginally significant. After adjusting for other known preterm birth risk factors, the frequency of preterm birth was almost three times higher among women who had UCL levels greater or equal to 5.1 microgram/dl compared to those who had UCL levels lower than 5.1 microgram/dl. This difference was not observed among multiparous women. Our results suggest that intrauterine lead exposure may be associated with preterm birth in first deliveries but not in subsequent ones.

Adolescent↗
PubMed1993

HPV, HIV infection, and risk of cervical intraepithelial neoplasia in former intravenous drug abusers.

The relation between human immunodeficiency virus (HIV), human papilloma virus (HPV) infection, sexual habits, reproductive history, and risk of cervical intraepithelial neoplasia (CIN) has been analyzed in a cross-sectional study conducted since 1986 among female former intravenous drug abusers attending for the first time to the Colposcopic Unit of the Ospedale Luigi Sacco of Milan and women consecutively admitted to the Community for Past Drug Abusers, S. Patrignano, Rimini. A total of 434 subjects entered the study; of those 128 (30%) had a diagnosis of CIN. Compared with HIV-negative subjects, odds ratio (OR) of CIN was 8.0 (95% confidence interval (CI) 4.6-14.1) for HIV-positive ones and the frequency of CIN 2 and 3 was higher in HIV-positive than that in HIV-negative subjects (chi 2(1), trend, 6.67, P 0.01). Compared with women without current HPV infection the OR estimate was 38.0 (95% CI 20.3-71.2) in those with current diagnosis of HPV infection. Considering HIV-positive subjects only, the frequency of CIN increased with stage of HIV infection and was higher in women with lower CD4+ values. Finally, no relation emerged between CIN risk and age, indicators of sexual habits, oral contraceptive use, parity, and history of spontaneous or induced abortions.

Adult↗
PubMed1995

Spontaneous abortion and risk of fatal breast cancer in a prospective cohort of United States women.

Controversy exists over the possible relationship between induced and spontaneous abortion and risk of breast cancer. Thus, the association of fatal breast cancer and spontaneous abortion was examined in a large prospective study of United States adult women. After seven years of follow-up, 1,247 cases of fatal breast cancer were observed among 579,274 women who were cancer-free at interview in 1982 and who provided complete reproductive histories. Results from Cox proportional hazards models, adjusted for other risk factors, showed no association between a history of spontaneous abortion and risk of fatal breast cancer (rate ratio [RR] = 0.89, 95 percent confidence interval [CI] = 0.78-1.02). The RR did not increase with increasing numbers of abortions. Parous women who had a spontaneous abortion before their first term birth were not at increased risk compared with parous women with no history of spontaneous abortion (RR = 0.76, CI = 0.54-1.05). Women whose only pregnancy ended in a spontaneous abortion were not at increased risk compared with women who were never pregnant (RR = 0.61, CI = 0.27-1.38) or whose only pregnancy ended in a livebirth (RR = 0.72, CI = 0.32-1.65). These findings do not support an association between spontaneous abortion and fatal breast cancer.

Abortion, Spontaneous↗
PubMed1992

Progetto ATENA, a study on the etiology of major chronic diseases in women: design, rationale and objectives.

In spite of their important impact on populations, a number of diseases--all types of cancer and coronary heart disease in women--are "rare" events for statistical analysis and often analyzed in designs affected by selection and information biases, such as case-control studies. Large cohort studies based on the storage of biological specimens appear to be the most suitable solution for identifying risks for those diseases. Progetto ATENA, a study on the etiology of major chronic diseases in women is based on this design. Ten thousand women, aged 30-69 years, living in the area of the city of Naples, free of cancer and cardiovascular disease, are being recruited over a four-year period. Ten per cent of the cohort is being randomly selected from the electoral roles, the rest will be volunteers. Information on dietary habits, reproductive history, familiarity for chronic disease, active smoking habits and passive smoking exposure, physical activity, and socio-demographic data are being collected. Clinical data such as blood pressure, anthropometry, and electrocardiogram are also taken. All the participants provide biological samples of blood (fasting drawing) and urine (timed morning spot). The biological samples are processed in order to explore the main areas under study (nutritional markers, metabolism, endocrinology, genetics, environmental exposure markers, thrombogenesis). The samples are stored in liquid nitrogen (-196 degrees C) as soon as the blood and urine processing have been finished. An appropriate follow-up information system on the health status of the participants is being set up to estimate incidence and mortality rates.

Adult↗
PubMed1983

Ovarian cancer. Geographical, host and environmental factors. An overview.

The incidence of ovarian cancer is reviewed among different races and ethnic groups. We present the effect of socio-economic class, age, endocrinological factors, menstrual cycle, reproductive history, familial, and genetic factors, viral infections, chemical carcinogens, and previous exposure to radiation on the incidence of ovarian cancer. There is evidence that environmental factor affects the distribution of various types of ovarian cancer. Migration may also change the susceptibility to this disease and the mean age was varied between countries being lowest where incidence was highest. The disease appeared to have a familial incidence. The protective effect of oral contraceptive steroids and the role of asbestos as a chemical carcinogen are discussed.

Adolescent↗
PubMedDate not supplied

Metastasis of mammary tumours in mice: relationship with morphology of primary tumour, and reproductive background of host.

The lungs of BR6 breeding female mice which had developed spontaneous mammary tumours, were examined histologically for the presence of metastases. Metastatic nodules, or tumour cell emboli within blood vessels, were found in the lungs of 3 out of 42 (7 per cent) mice with pregnancy-dependent tumours, and in 33 out of 117 (28 per cent) mice with pregnancy-independent tumours. In general, primary tumours which were well-differentiated and organized were less likely to metastasize than poorly-differentiated ones, but there was an intermediate range within which the likelihood of metastasis could not be predicted. Analysis of the reproductive histories of the mice did not show any significant correlations between factors which might have influenced the growth and progression of the primary tumour and metastatic potential. However, the sustained presence of a high tumour load was associated with an increased probability of metastasis.

Age Factors↗
PubMed1995

Epidemiology of eclampsia.

The purpose of this study was to examine the risk of eclampsia in relation to several maternal characteristics and exposures, including demographic characteristics, reproductive history, and tobacco use during pregnancy. A case control study was conducted using data for all singleton births from the Washington State birth certificates for 1984-1990. In the check box feature employed by these certificates, eclampsia is listed under maternal conditions. Risk estimates, adjusted for various confounders, were calculated comparing eclampsia among exposed versus unexposed women. The risk of eclampsia was elevated in women without prenatal care, those with weight gain of more than thirty pounds during pregnancy, nulliparous women, and those with chronic hypertension. The association with tobacco smoking were inverse and dose related. Women's race, urban or rural place of residence, history of pre-term births, and anemia were not associated with eclampsia. Our data reaffirm the importance of prenatal care, and provide further evidence of an inverse relationship with prenatal smoking. As eclampsia and pre-eclampsia are important pregnancy complications, further research is needed to explore their possible causes.

Adolescent↗
PubMed1996

Experimentally induced mammary tumors in rats.

Among the multiple experimental animal models employed for analyzing the various aspects of mammary carcinogenesis, the induction of mammary tumors in rats by chemical carcinogens is one of the models most utilized. Experimentally-induced mammary tumors in rodents have proven to constitute useful tools for the study of the pathogenesis of cancer and of the molecular mechanisms involved in the initiation and progression of the neoplastic process. In vivo experimental animal models provide information not available in human populations; they are adequate for hazard identification, dose-response modeling, exposure assessment, and risk characterization, the four required steps for quantifying the estimated risk of cancer development associated with toxic chemical exposure. Using the DMBA rat mammary model, we have been able to demonstrate that the carcinogen acts on the intermediate cell of the terminal end bud (TEB), and that this structure is the one that evolves to intraductal proliferation, carcinoma in situ, and invasive carcinoma. There are several factors that regulate the susceptibility of the TEB; some of them are: a) topographic location of the mammary gland, b) age of the animal, and c) reproductive history. The understanding of the mechanisms that modulate tumorigenesis will further our knowledge and understanding in the prevention of the disease, as a result of the development of strategies for stopping the progression of the initiated cells.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1989

Histopathologic and dietary prognostic factors for canine mammary carcinoma.

Histologic and dietary prognostic factors for survival following naturally occurring breast cancer were studied for 145 pet dogs. Information was collected from the dog's owner and veterinarian regarding medical and reproductive history, nutritional status, treatment, tumor recurrence, and length of survival. The usual intake of all dog and table foods consumed 1 year prior to diagnosis was obtained using a validated quantitative food frequency questionnaire. A histologic malignancy score was derived based on 7 histopathologic criteria. The mean age of the dogs was 10.4 +/- 2.5 years; 37% had been ovariohysterectomized prior to diagnosis. Product-limit estimates of survival indicated that 6 factors, namely body conformation 1 year prior to diagnosis (p = 0.03), histologic tumor type (p = 0.004), histologic malignancy score (p = 0.02), histologic invasion (p = 0.002), tumor recurrence (p less than 0.0001), and completeness of surgery (p = 0.01) were of prognostic significance. In addition, when dogs were characterized by the percent of total calories they derived from fat and protein, the median survival time for dogs in the low fat group (less than 39%) with protein greater than 27%, 23-27%, and less than 23% was 3 years, 1.2 years, and 6 months, respectively (p = 0.008). For dogs in the high fat group (greater than or equal to 39%), there was no difference in survival for the different intake levels of dietary protein (p = 0.84). When these data were fitted to a proportional hazards model, recurrence, histologic score, tumor type, percent of calories derived from protein, fat group, and a protein-fat group interaction term were statistically significant. Predicted 1 year survival for dogs on a low fat diet with 15%, 25%, and 35% of total calories derived from protein was 17%, 69%, and 93%, respectively.

Animals↗
PubMed1992

Influence of age and parity on the development of the human breast.

Breast cancer is heavily influenced by the reproductive history of the individual. Pregnancy has a protective effect which is attributed to differences in the degree of differentiation of the breast. The purpose of this work was to determine whether the quantity and the type of parenchymal structures present in the human breast were related to the age and parity history of a woman. Fifty-one human breast samples were obtained from bilateral or unilateral reduction mammoplasties performed in 40 parous women ranging in age from 18 to 57 years, and 11 nulliparous women ranging in age from 14 to 54 years. An average of 100 grams of tissue/specimen were processed for whole mount. A total of 650 slides were examined and 31,222 structures were classified and counted under the light microscope. The following mammary structures were identified: terminal structures (TS), and lobules (LOB) type 1, 2, and 3. Results were plotted for the total patient population and separately for nulliparous and parous women against age. The total patient population contained similar proportions of LOb1, 2, and 3 between ages 14-18, with a reduction of percentage of Lob1 and increase in Lob3 between ages 23 to the middle forties, when Lob3 decreased and Lob1 increased to 70%. Lob2 and TS did not exhibit significant changes throughout the period of life analyzed. When analyzed separately it was found that the breasts of nulliparous women were predominantly composed of Lob1, fewer Lob2, with Lob3 almost completely absent, whereas parous women had a high frequency of Lob3, which were the predominant structures until the fourth decade of life.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Potential risk factors for development of postmenopausal osteoporosis--examined over a 12-year period.

In a longitudinal study, we investigated the influence of risk factors on bone mass at menopause and postmenopausal bone loss in 121 healthy postmenopausal women. These women had completed a 2-year prospective study in 1979 and a follow-up examination in 1989. Measurements of the bone mineral content in the distal forearm (single photon absorptiometry) were performed 9 times during the initial study and once at the follow-up examination. Bone mass at menopause (initial measurement), rate of early postmenopausal bone loss, and the subsequent rate of bone loss over 10 years were thus determined. In addition, the bone mineral density of the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry (DXA) in 1989. Information about risk factors was assessed by standardized questionnaires and included reproductive history and lifestyle factors (intake of calcium and vitamin D supplements, consumption of alcohol and caffeine, smoking habits, and physical activity). Lactation, oral contraceptive use, and dietary calcium intake above 1500 mg per day was associated with significantly increased bone mass at menopause. The number of pregnancies reduced the rate of early postmenopausal bone loss, whereas moderate alcohol consumption reduced the subsequent rate of bone loss. Smoking significantly reduced femoral bone mineral density. In conclusion, the present prospective study showed that some of the examined putative risk factors positively influenced bone mass at menopause, especially calcium intake, whereas the postmenopausal bone loss was virtually unaffected. Assessment of risk factors in postmenopausal women thus seems to have limited value for reducing future risk of osteoporosis.

Aged↗
PubMed1981

Influence of age and parity on the susceptibility of rat mammary gland epithelial cells in primary cultures to 7,12-dimethylbenz(a)anthracene.

Mammary gland epithelial cells from rats of different ages or with different reproductive histories vary in their proliferative properties and susceptibility to dimethylbenz(a)anthracene (DMBA) carcinogenesis in vivo. The present study was carried out to determine whether these differences are maintained under in vitro conditions. Primary cultures of mammary gland epithelial cells of young virgin, old virgin, and parous rats were treated with various doses of DMBA. Growth rates, DNA synthesis, and dose-response curves were determined; the toxicity of DMBA was measured by its effect on cell growth. Cell morphology was studied by transmission and scanning electron microscopy. Epithelial cells from the mammary gland of young virgin rats adapted rapidly to the culture conditions, behaving as if the cells were in the logarithmic phase of growth prior to plating. Mammary gland epithelial cells from old virgin and parous rats required a lag period prior to cell growth during which the proliferating cells adapted to the culture conditions. Cells from each group had comparable doubling times, and DNA synthesis peaked approximately 1 d after initiation of growth in culture. The numbers of proliferating cells decreased with increasing age and parity of the donor. Mammary gland epithelial cells of young virgin rats were more susceptible to both low and high doses of DMBA than those of old virgin and parous rats when the carcinogen was added either 24 h after plating or at the peak of DNA synthesis. These results indicate that age and parity influence the proliferative status of the cells and their susceptibility to DMBA in vitro, simulating in that way the in vivo situation.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed2005

[Application of the Gail method of calculating risk in the population of Valencia].

BACKGROUND: The objective of this study was to verify whether the method defined by Gail is applicable and predictive in a population of women in Valencia (Spain). POPULATION AND METHODS: Of the 685 patients diagnosed with breast cancer and attended-to in 2000-2001, 186 incident cases were identified. The variables studied were obtained from a specific questionnaire which included characteristics of reproductive history, number of biopsies and contraceptive pill consumption prior to the diagnosis. Using the model of the National Surgical Adjuvant Breast and Bowel Project (NSABP), an adaptation of the Gail model, the risk of developing breast cancer at 5 years was estimated. RESULTS: Only 40% of those women diagnosed as having breast cancer would have been identified as a high-risk patient by the Gail method. With our population group, the method detected the elderly women with a medical history of breast cancer who developed advanced stage disease. CONCLUSIONS: The Gail method does not adapt well to the study population of Valencia. It would be necessary to add other risk-factors to the Gail method so as to identify more patients in our area.

Adult↗