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PubMed2006

Human papillomavirus infection in Shanxi Province, People's Republic of China: a population-based study.

To investigate the prevalence of, and risk factors for, cervical infection with human papillomavirus (HPV) in the rural province of Shanxi, People's Republic of China, which has relatively high cervical cancer mortality rates, we interviewed and obtained cervical cell samples from 662 women aged 15-59 years. A total of 24 different HPV types were identified using a GP5+/6+-based PCR assay able to detect 44 different HPV types. Human papillomavirus prevalence was 14.8% overall and 9.6% among women without cervical abnormalities (14.2 and 8.9%, respectively, age standardised to the world standard population). Multiple-type infections accounted for 30.6% of all infections. By far the most commonly found type was HPV16 (5.7% of all women and 38.8% of HPV-positive women), followed by HPV 58, 52, 33 and 18. Unlike most previous studies published, HPV prevalence was lower among women younger than 35 years (8.7%) than those older than 35 years (17.8%). High-risk HPV types predominated in all age groups. Although low-risk HPV types were rare in young women, they became more common with increasing age. 92.3% of women with cervical intraepithelial neoplasia grade 3 were infected with high-risk HPV types, but none with low-risk types only. No significant difference in HPV positivity was observed by educational level, sexual habits, reproductive history or use of contraceptive methods in this rural low-income Chinese population.

Adolescent↗
PubMed1998

Low body mass index in non-meat eaters: the possible roles of animal fat, dietary fibre and alcohol.

OBJECTIVE: To examine the associations of diet and other lifestyle factors with body mass index (BMI) using data from the Oxford Vegetarian Study. SUBJECTS: 1914 male and 3378 female non-smokers aged 20-89 y at recruitment to the study. MEASUREMENTS: All subjects completed a diet/lifestyle questionnaire at recruitment giving details of their usual diet and other characteristics including height and weight, smoking and drinking habits, amount of exercise, occupation and reproductive history. Answers to the food frequency questionnaire were used to classify subjects as either meat eaters or non-meat eaters, and to estimate intakes of animal fat and dietary fibre. Subjects were further classified according to their alcohol consumption, exercise level, social class, past smoking habits and parity. RESULTS: Mean BMI was lower in non-meat eaters than in meat eaters in all age groups for both men and women. Overall age-adjusted mean BMIs in kg/m2 were 23.18 and 22.05 for male meat eaters and non-meat eaters respectively (P < 0.0001) and 22.32 and 21.32 for female meat eaters and non-meat eaters respectively (P < 0.0001). In addition to meat consumption, dietary fibre intake, animal fat intake, social class and past smoking were all independently associated with BMI in both men and women; alcohol consumption was independently associated with BMI in men, and parity was independently associated with BMI in women. After adjusting for these factors, the differences in mean BMI between meat eaters and non-meat eaters were reduced by 36% in men and 31% in women. CONCLUSIONS: Non-meat eaters are thinner than meat eaters. This may be partly due to a higher intake of dietary fibre, a lower intake of animal fat, and only in men a lower intake of alcohol.

Adult↗
PubMed2000

The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy.

OBJECTIVES: To assess the relationships between gestational gain, race/ethnicity, reproductive history, age, education and the risk of becoming overweight after pregnancy. STUDY DESIGN: Prospective cohort study of adult women from four race/ethnicity groups who had two consecutive births between 1980 and 1990 at the University of California, San Francisco (UCSF). MEASUREMENTS: Height and pregravid weights for each pregnancy were self-reported. Women were classified as overweight or not overweight according to the Institute of Medicine (IOM) criteria for pregnancy. Gestational gain was defined as the difference between the pregravid weight and the last weight before delivery of the first study pregnancy. SUBJECTS: 1300 healthy women aged 18-41 y who had a singleton, full-term, live birth (index or first study pregnancy) followed by a second birth. Self-reported pregravid weights and heights were used to calculate body mass index (BMI). Women with a pregravid BMI below 26.0 kg/m2 before the index pregnancy were classified as not overweight (n = 1128). Overweight status following the index pregnancy was based on pregravid BMI for the second pregnancy. RESULTS: Seventy-two women (6.4%) became overweight following the index pregnancy. Statistically significant independent predictors of the risk of becoming overweight included: maternal age 24-30 vs above 30 y, high gestational gain, short interval from menarche to first ever birth ( < 8 y), and young age at menarche ( < 12 y). The risk of becoming overweight was increased 2.5-3 times for each of these risk factors. Whites were 4.5 times more likely to become overweight than Asians, but blacks and Hispanics did not appear to differ from whites. Parity, time interval, smoking habit, education, marital status and other factors were not associated with the risk of becoming overweight. CONCLUSIONS: These findings suggest that young age at menarche, maternal age and short time from menarche to first ever birth may be as important as high gestational weight gain in determining the risk of becoming overweight after pregnancy.

Adolescent↗
PubMed2006

Modifiers of risk of hereditary breast cancer.

Mutations in the BRCA1 and BRCA2 genes confer a high lifetime risk of breast and ovarian cancer. The risk varies from individual to individual, and it appears that the risk has increased in recent generations. These observations imply that non-genetic factors may modify the inherited risk. To date, the factors that appear most strongly to modify the risk include reproductive histories and exogenous hormones. Oral contraceptives are associated with a profound reduction in the risk of ovarian cancer, and with little or no increase in the risk of breast cancer. Other modifying factors include age of menarche, parity, breastfeeding and oophorectomy. The effect of parity is different in BRCA1 and BRCA2 carriers. Multiparity appears to be protective in BRCA1 carriers, but is associated with an increase in risk in BRCA2 carriers. Oophorectomy has been associated with reductions in both the risk of breast and ovarian cancer. Knowledge of these risk factors will be useful for managing risk and for developing prevention strategies.

Abortion, Therapeutic↗
PubMed1999

Effect of freeze-thawing procedure on chromatin stability, morphological alteration and membrane integrity of human spermatozoa in fertile and subfertile men.

Cryopreservation is known to impair sperm motility and decrease the fertilization rate by detrimental effects on acrosomal structure and acrosin activity. However, the consequences of cryopreservation on the integrity of the sperm nucleus, chromatin stability and centrosome are less clear. The present study was designed to determine the effect of the freeze-thawing procedure on chromatin condensation (aniline blue staining) and the morphology (strict criteria) and membrane integrity of human spermatozoa. The structural and functional characteristics of the sperm plasma membrane were measured by the eosin-test and hypo-osmotic swelling test which were done separately. Sperm cryopreservation was performed on semen samples from two groups of men classified as fertile (n = 20) and subfertile (n = 72), based on their reproductive history and semen analysis according to WHO guidelines. The mean percentage of condensed chromatin, morphologically normal spermatozoa and membrane integrity in all semen samples investigated (n = 92) decreased significantly (p = 0.0001) after freeze-thawing, in comparison to the value observed prior to freezing. By comparing the semen samples between fertile and subfertile patients, significantly (p = 0.0009) greater damage was demonstrated in the subfertile than in the fertile group. Furthermore, no significant difference was observed between the two groups with regard to the morphological alteration and structural as well as functional damage of the sperm membrane. In conclusion, the freeze-thawing procedure significantly affects chromatin structure and sperm morphology, especially in the head and the tail regions, and this may explain the lower fertilization rate and IVF/ICSI outcome when frozen-thawed spermatozoa are used. In addition, this study demonstrates that chromatin condensation is a sensitive parameter for the evaluation of cryodamage of semen samples from fertile and subfertile patients, though subfertile patients with very poor semen characteristics have yet to be studied. It is therefore recommended that chromatin condensation be used as an additional parameter for the assessment of sperm quality after freeze-thawing.

Cell Membrane↗
PubMed2001

Childbearing and the risk of parathyroid adenoma--a dominant cause for primary hyperparathyroidism.

OBJECTIVES: To explore possible associations between the reproductive history amongst women and the risk of parathyroid adenoma (PA). DESIGN: Two nationwide Swedish registries. The Fertility Register included data on more than 3.4 million livebirths between 1943 and 1992 amongst Swedish females born 1925-72. The Cancer Register encompasses more than 1800 women with a diagnosis of PA 1960 until 1992. SETTING: All women resident in Sweden 1960-92. SUBJECTS: Cases were all 1800 women born 1925-72 reported to the Swedish Cancer Registry with a histopathological diagnosis of PA. Five controls were selected at random for each case by matching for the month and year of birth. Conditional logistic regression was used to estimate relative risks of PA. MAIN OUTCOMES: Parathyroid adenoma. RESULTS: High parity (four or more live births) was associated with an increased risk of PA. Amongst women with a diagnosis of PA before menopause (i.e. the age of 50 years) there was an increased risk of PA with younger age at first childbirth. Nulliparous women were at increased risk for PA before menopause, and at decreased risk after menopause. CONCLUSIONS: There is an association between childbearing and the risk of PA, which has not previously been demonstrated, but the underlying biological mechanisms remain to be determined.

Adenoma↗
PubMed1999

Age structure of overwintered face fly populations estimated by pteridine concentrations and ovarian dynamics.

Pteridines in the head capsules of face flies, Musca autumnalis DeGeer, were measured spectrofluorometrically to provide estimates of age. The flies also were dissected to determine ovarian development and fat body hypertrophy. Physiological ages in terms of degree-day accumulations were estimated among late autumn, winter, and early spring face flies. The reproductive history of eight overwintered face fly populations near Ames, Iowa, U.S.A., suggested that each had behaved as a single cohort, maturing their eggs and ovipositing according to a simple heat unit model. 83.8 +/- 16.4 degree-days above a 12 degrees threshold (DD > 12 degrees) were estimated to elapse between 1 January and the date at which 50% of overwintered cohorts had oviposited. Pteridine deposits indicated that diapausing females in late autumn had acquired a mean 96 +/- 36 DD > 9.8 degrees and the males 135 +/- 39 DD > 9.8 degrees. Soon after emergence from hibernaculae, females were average physiological ages of 135 +/- 25 DD > 9.8 degrees and the males were 152 +/- 28 DD > 9.8 degrees. Mean physiological age of overwintered females was 155 +/- 37 DD > 9.8 degrees compared with 110 +/- 38 DD > 9.8 degrees among parous flies in summer. Overwintered males in spring were an average 175 +/- 41 DD > 9.8 degrees compared with 144 +/- 65 DD > 9.8 degrees among summer flies.

Animals↗
PubMed2003

A cohort study of reproductive risk factors, weight and weight change and the development of diabetes mellitus.

AIMS: Reproductive factors (parity, miscarriages, terminations), oral contraceptive use, hormone replacement therapy, body weight at first pregnancy and weight gain following pregnancy may be associated with a long-term risk of diabetes. The aim of this study is to investigate the independent risks of reproductive factors and body weight for diabetes in later life. METHODS: This is a retrospective cohort study of 1257 parous women who had a first pregnancy between 1951 and 1970. Reproductive history, weight and height were measured at the time of first pregnancy, then assessed by questionnaire in 1997 for all women. A clinical examination and an analysis of blood samples were undertaken for 992 women. The main outcome was incidence of diabetes based on medical history, medication and random glucose measurement. RESULTS: Sixty of the 1257 (4.8%) women developed diabetes. Body mass index at index pregnancy and after 28-48 years follow-up were both significantly associated with risk of diabetes, this increased with greater weight gain. There was a non-significant increased risk of diabetes associated with stillbirths and miscarriages after age and BMI adjustment. CONCLUSIONS: In parous women, higher BMI at index pregnancy, weight gain during follow-up and BMI in later life strongly predict diabetes risk.

Abortion, Induced↗
PubMed2002

Methodologic considerations for population-based research on fetal deaths: overcoming data gaps.

Fetal deaths comprise a large component of perinatal mortality and remain an understudied pregnancy outcome, especially from a population perspective. Interpretation of the findings from clinical or community-based studies can be difficult without a clear understanding of fetal death at the population level. This article addresses the critical data gaps underlying population-based research on fetal deaths, including the magnitude and scope of the problem, the probability of occurrence, the populations at risk, and the importance of accounting for prior reproductive history. Suggestions are given for new avenues of population-based research such as prospective inquiry of couples attempting pregnancy and newer analytic and modeling strategies for assessing risk and for addressing the lack of independence in pregnancy outcomes.

Female↗
PubMed1999

Ovarian morphology and follicular systems in yaks of different ages.

Forty-five female yaks of different ages with known reproductive histories were used to determine the morphology and follicular systems of their ovaries. The histological structure of the ovaries in each age group was found to be similar and resembled that of cattle and buffalo. The atresia of primordial follicles took one form (oocyte atresia); that of growing follicles could be divided into two stages (early and late); and that of Graafian follicular were classified as early, definite and late stage. The details of the several types of atresia are described herein. The average total numbers of primordial follicles per ovary pair in 1-month-old calves, 1-year-old heifers, 2-year-old heifers and 7-10-year-old cows were 53,500 +/- 6300, 32,870 +/- 4500, 22,850 +/- 2800 and 9500 +/- 1200, respectively; those of growing follicles were 210 +/- 76, 815 +/- 95, 895 +/- 142 and 445 +/- 88, respectively; and those of Graafian follicles were 36.5 +/- 14.2, 41.7 +/- 12.3, 37.8 +/- 9.8 and 42.5 +/- 14.5, respectively. The percentage of atretic primordial follicles per ovary pair in 1-month-old calves, 1-year-old heifers, 2-year-old heifers and 7 to 10 year-old cows were 51.6, 55.5, 56.7 and 47.4%, respectively. The average total numbers of atretic growing follicles per ovary pair were 119.5 +/- 21.5, 605.5 +/- 74.3, 721.6 +/- 78.5 and 275.8 +/- 66.3, respectively; those of atretic Graafian follicles were 22.1 +/- 5.6, 21.2 +/- 7.6, 21.5 +/- 4.7 and 25.3 +/- 6.7, respectively.

Aging↗
PubMed1999

An anatomical study of the internal genital organs of the yak at different ages.

Forty-five female yaks of different ages with known reproductive histories were used to determine the anatomical characteristics of their internal genital organs. The results showed that there were several follicles of different sizes present on the surface of each examined ovary, up to a maximum of 13. In each age group, a greater number of follicles < 5 mm was observed in the right than in the left ovary (P < 0.05), while the number of follicles > 5 mm in the right ovary was almost the same as that in the left one. The average sizes and/or weights of the ovary, oviduct and uterus became larger or heavier with increasing age, and significant differences occurred between age groups (P < 0.05). The shapes, locations and other anatomical characteristics of the different internal genital organs are also described.

Aging↗
PubMed2000

Relative accuracy of the identification of ovarian structures in the cow by ultrasonography and palpation per rectum.

Manual palpation or ultrasonographic examination of the cow's genital tract are currently used by veterinarians involved in reproductive management, but knowledge of the potential and the limitations of both methods is important to obtain an optimal accuracy in the diagnosis of physiological and pathological ovarian structures. This review presents the main features of manual and ultrasonographic characteristics of follicles, corpora lutea (with or without a cavity), follicular and lutenized cysts and the reliability of the two methods is compared. Manual diagnosis of follicles <10 mm is rather inaccurate, but ultrasound offers the possibility to diagnose follicles <5 mm and to measure their inner diameter. The predictive values of the presence or absence of a corpus luteum as determined by palpation are similar (78 vs. 75%). Manual or ultrasonographic diagnosis of the growing or regressing corpus luteum is rather difficult. The positive predictive value of a mature corpus luteum diagnosed by ultrasonography is lower (87%) than the negative predictive value (92%). Compared to manual palpation, ultrasonography permits a better estimation of the number and to determine more precisely the size of the mature corpus luteum. The positive values for follicular cysts diagnosed by palpation or by ultrasonography are 66 and 74% respectively, and for luteal cysts, the values are 66 and 85%, respectively.Manual palpation or ultrasonography are useful tools to diagnose ovarian structures in the cow. The accuracy of such methods can be enhanced by securing information on the reproductive history of the animal, palpation of uterine horns, vaginal examination or progesterone determinations.

Animals↗
PubMed2001

Birth order, family size, and the risk of cancer in young and middle-aged adults.

We used the Swedish Family-Cancer Database to analyse the effects of birth order and family size on the risk of common cancers among offspring born over the period 1958-96. Some 1.38 million offspring up to age 55 years with 50.6 million person-years were included. Poisson regression analysis included age at diagnosis, birth cohort, socio-economic status and region of residence as other explanatory variables. The only significant associations were an increasing risk for breast cancer by birth order and a decreasing risk for melanoma by birth order and, particularly, by family size. When details of the women's own reproductive history were included in analysis, birth orders 5-17 showed a relative risk of 1.41. The effects on breast cancer may be mediated through increasing birth weight by birth order. For melanoma, socio-economic factors may be involved, such as limited affordability of sun tourism in large families. Testis cancer showed no significant effect and prostate cancer was excluded from analysis because of the small number of cases.

Adolescent↗
PubMed2001

High bone-mass density as a marker for breast cancer in post-menopausal women.

Bone mass has been proposed as a marker of cumulative exposure to oestrogen in women. We have studied the association between bone mass and breast cancer in postmenopausal women. In 126 cases of breast cancers and 126 controls, the bone mineral density (BMD) of the lumbar spine (L2-L4), femoral neck, trochanter and Ward's triangle was measured by dual-energy X-ray absorptiometry. All cases of cancer were confirmed by pathological reports. A questionnaire including information on reproductive history and other variables was collected. BMD was significantly higher among breast cancer patients than controls at all sites, except at the femoral neck where BMD was increased in the cancer group, but not significantly. After adjustment for potential confounding factors, the estimated relative risk of breast cancer in the highest quartile of BMD compared to the lowest quartile ranged from 2.5 to 4.8 for various sites of measurement. These results confirm that bone-mass density is a strong predictor for breast cancer in postmenopausal women. Women in the lowest quartile of bone mass appear to be protected against breast cancer. The mechanisms underlying this relation may be explained by cumulative exposure to oestrogen.

Journal Article↗
PubMed2000

Anatomic factors associated with recurrent pregnancy loss.

Anatomic uterine defects appear to predispose women to reproductive difficulties, including first- and second-trimester pregnancy losses, higher rates of preterm labor and birth, and abnormal fetal presentation. These anatomic abnormalities can be classified as congenital, including müllerian and diethylstilbestrol-related abnormalities, or acquired, such as intrauterine adhesions or leiomyomata. In women with three or more consecutive spontaneous abortions who underwent hysterosalpingography or hysteroscopic examination of their uteri, mullerian anomalies have been found in 8 to 10%. Women with mullerian anomalies may be predisposed to recurrent pregnancy loss because of inadequate vascularity to the developing embryo and placenta, reduced intraluminal volume, or cervical incompetence. The reproductive history of most women with a müllerian anomaly is poor, especially for women with a uterine septum, the most common mullerian anomaly. Recurrent pregnancy losses resulting from a uterine septum, bicornuate uterus, intrauterine adhesions, and fibroids are amenable to surgical correction. Women with müllerian anomaly and a history of second-trimester pregnancy losses may benefit from a prophylactic cervical cerclage.

Abortion, Habitual↗
PubMed1987

[Endocrine profile of patients with post-pill amenorrhea].

"Post-pill amenorrhea" is still a much-debated subject in gynecological endocrinology. The authors therefore studied the reproductive history and endocrinological parameters of 145 patients with the presumptive diagnosis of post-pill amenorrhea, seen in their department during the last two years; 166 cases of secondary amenorrhea served as a control group. The incidence of late menarche (20%), previous oligomenorrhea, and elevated androgen serum levels was high in both groups. There were no significant differences between the two collectives. These findings suggest that although oral contraceptives may have an unfavorable influence on the menstrual cycle, there is no causal relationship between such agents and the development of secondary amenorrhea. It seems that in many cases of presumptive post-pill amenorrhea the common condition of juvenile hyperandrogenemic ovarian insufficiency might be the underlying problem.

Adolescent↗
PubMed2002

Low serum level of mannan-binding lectin is a determinant for pregnancy outcome in women with recurrent spontaneous abortion.

OBJECTIVE: The purpose of this study was to investigate the genetic background for the previously reported finding of an increased frequency of low levels of mannan-binding lectin in couples with unexplained recurrent spontaneous abortion and to evaluate the impact of low mannan-binding lectin levels on future pregnancy outcome. STUDY DESIGNS: Mannan-binding lectin levels were measured in 217 women with unexplained recurrent spontaneous abortion and 111 of their husbands and were compared with corresponding measurements in 104 couples with uncomplicated reproductive histories and 210 blood donors. An investigation of the genetic polymorphism, which is largely responsible for serum mannan- binding lectin levels, was done by polymerase chain reaction methods with DNA from a subset of the patients and control subjects. Information was collected about the outcome of the patients' next pregnancies, together with perinatal data concerning the patients' first birth that occurred before or after being assigned to the study. RESULTS: Among women with recurrent spontaneous abortion, 18.9% of the women had mannan-binding lectin levels of </= 100 ng/mL compared with 12.2% of control subjects ( P =.02). An investigation of mannan-binding lectin levels and genetic analyses gave no evidence that paternal mannan- binding lectin deficiency plays a role for recurrent spontaneous abortion. Patients with mannan-binding lectin levels of </=100 ng/mL had a higher abortion rate than patients with normal mannan- binding lectin levels (P <.05). The median birth weight of children who were born at term of women with recurrent spontaneous abortion was 287 g less in women with mannan-binding lectin levels of </= 100 ng/mL than that of patients with normal mannan-binding lectin levels (P =.04). CONCLUSION: Low maternal serum mannan-binding lectin levels exhibit a negative impact on pregnancy outcome in women with unexplained recurrent spontaneous abortion.

Abortion, Habitual↗
PubMed2003

Weight at birth and subsequent risk of preeclampsia as an adult.

OBJECTIVE: We examined the influence of maternal birth weight on the risk of the development of preeclampsia, a likely precursor to adult chronic disease. STUDY DESIGN: This hospital-based case-control study included 181 preeclampsia cases and 349 control subjects. Participants provided information about their birth weight and other covariates that included medical and reproductive history, prepregnancy weight, and adult height. Odds ratios and 95% CIs were estimated by logistic regression. RESULTS: The risk of preeclampsia decreased as maternal birth weight increased (P=.01). After an adjustment was made for confounders, data showed that women with a low birth weight (<2500 g) had a 2.3-fold increased risk of experiencing preeclampsia (95% CI, 1.0-5.3) as compared with women who weighed 2500 to 2999 g at birth. Conversely, women with a birth weight of >/=4000 g appeared to have a nonstatistically significant, but >50%, reduction in the risk of experiencing preeclampsia (95% CI, 0.2-1.2). This relationship differed for lean and overweight women (body mass index, <25 kg/m(2) vs >/=25 kg/m(2)). Among lean women, those who were low birth weight had a near doubling in risk of the development of preeclampsia (odds ratio, 1.9; 95% CI, 0.8-4.6), although this association did not reach statistical significance. However, among overweight women, those women who weighed <2500 g at birth had an almost 4-fold increased risk of experiencing preeclampsia (odds ratio, 3.8; 95% CI, 1.1-13.8). CONCLUSION: These results confirm two earlier reports and expand the literature by showing that women who are small at birth and who become overweight as adults are at particularly high risk of the development of preeclampsia.

Adult↗