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PubMed2007

Chlamydia trachomatis infections increase the risk for ectopic pregnancy: a population-based, nested case-control study.

BACKGROUND: Chlamydia trachomatis (CT) as a risk factor for ectopic pregnancy (EP) has mainly been established through seroepidemiologic cross-sectional studies. GOAL: The goal of this study was to obtain EP risk estimates for women diagnosed with CT using women with negative tests as the reference group. METHODS: We linked prospectively collected CT laboratory data (1990-2003) to EP hospital data (discharge and outpatient registries) in a nested case-control study. Six hundred sixteen women with CT test(s) before first EP were eligible as cases. Three controls were matched to each case for year of birth, age at first test, and number of prior tests. RESULTS: Previous CT infection was associated with elevated EP risk (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.0-2.0). In stratified analysis, the association was only significant for the youngest women (born 1970-1984) who had a nearly complete CT testing history (OR, 2.1; 95% CI, 1.3-3.2). CONCLUSION: A history of diagnosed CT infection is associated with a 2-fold increased EP risk.

Adult↗
PubMed2004

Use of TaqMan 5' nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic.

Mycoplasma genitalium is a cause of nongonococcal urethritis, particularly in patients not infected with Chlamydia trachomatis. A quantitative 5' nuclease assay (TaqMan PCR) was developed and validated. The assay detected a fragment of the MgPa adhesin gene by use of a TaqMan MGB (minor groove binder) probe and included an internal processing control to detect PCR inhibition. Urethral swab specimens and first-void urine samples from M. genitalium-positive men were examined, and the M. genitalium DNA load was correlated to symptoms and signs. The assay consistently detected <5 genome copies without cross-reactions with other mycoplasmas. Urine and urethral swab specimens from men with urethritis had higher M. genitalium DNA loads than specimens from men without urethritis. However, a very broad overlap of DNA loads between patients with and without urethritis was observed. Urethral swab specimens from patients with urethral discharge had a significantly higher DNA load than specimens from patients without discharge. This correlation was not found in first-void urine specimens.

Base Sequence↗
PubMedDate not supplied

Reproductive biology of the slender loris (Loris lydekkerianus lydekkerianus).

The slender loris (Loris lydekkerianus lydekkerianus), a nocturnal prosimian, was studied for 21 months in its natural habitat of scrub jungle in Dindigul, south India. Here we report on its reproductive biology. Identified and unidentified lorises were observed for a total of 2,656 h. Reproductive seasonality was seen, with births and oestrus observed to be highest in April-June and October-December. The mating system was promiscuous with 1 female mating successively with 3-4 males. A gestation period of 5.5 months and an inter-birth interval of 7 months were recorded. Adult females had a reproductive potential of 4 infants per year. The findings presented in this paper constitute the first information on the life history parameters of wild slender lorises.

Animals↗
PubMed2002

Spectrum and progression of conduction abnormalities in infants born to mothers with anti-SSA/Ro-SSB/La antibodies.

The classic cardiac manifestation of neonatal lupus is congenital heart block, attributed to antibody-mediated inflammation and subsequent fibrosis of the atrioventricular (AV) node. In considering the pathologic process of injury it may be that tissue damage results in a range of conduction abnormalities. Identification of less-advanced degrees of block or of fibrosis around the AV node without any conduction abnormality on EKG would support this pathologic model, and serve as a potential marker for treatment if the conduction defect could be shown to progress. To ascertain the spectrum of arrhythmias associated with maternal anti-SSA/Ro-SSB/La antibodies, records of all children enrolled in the Research Registry for Neonatal Lupus were reviewed. Of 187 children with congenital heart block whose mothers have anti-SSA/Ro-SSB/La antibodies, nine had a prolonged PR interval on EKG at birth, four of whom progressed to more advanced AV block. A child whose younger sibling had third degree block was diagnosed with first degree block at age 10 years at the time of surgery for a broken wrist. Two children diagnosed in utero with second degree block were treated with dexamethasone and reverted to normal sinus rhythm by birth, but ultimately progressed to third degree block. Four children had second degree block at birth: of these, two progressed to third degree block. Sinus bradycardia (< 100 bpm) was present in three (3.8%) of 78 fetuses for whom atrial rates were recorded by echocardiogram. Of 40 neonates for whom EKGs were available, the mean atrial rate was 137+/-20 bpm (range 75-200). These data have important research and clinical implications. In contrast to the AV node, permanent sinoatrial nodal involvement is not clinically apparent. Perhaps many fetuses sustain mild inflammation, but resolution is variable, as suggested by the presence of incomplete AV block. Since subsequent progression of less-advanced degrees of block can occur, an EKG should be performed on all infants born to mothers with anti-SSA/Ro-SSB/La antibodies.

Antibodies, Antinuclear↗
PubMed1997

Thermographic demonstration of nonshivering thermogenesis in human newborns after birth: its relation to umbilical gases.

This study was undertaken to measure the extent of nonshivering thermogensis (NST) in brown adipose tissue of human newborns receiving routine thermal care and to examine the influence of oxygen levels at birth on the initiation of NST. Fifteen human neonates were studied in an incubator set at 31-31 degrees C. Thermographic measurements were made every 5 seconds for 5 minutes at 10 and 30 minutes, 1, 3, 6 and 24 hours, and 3 days after birth. The skin temperature and rate of heat dissipation from the interscapular area (location of subcutaneous brown adipose tissue), whole back area, and head area were measured. A heat dissipation ratio (HDR) was calculated as (A-B)/B, where A and B, expressed in Cal/cm2/h, represent rates of heat dissipation from the interscapular area and the whole back area, respectively. Umbilical arterial blood gases were measured immediately after birth. The skin temperature of the interscapular, whole back, and head areas increased significantly during the interval from 10 minutes to 1 hour after birth (p < 0.05). The skin temperature of the interscapular area was highest among the sampled sites during the first hour after birth (p < 0.05). The HDR was highest 10 minutes after birth (p < 0.05). By 1 hour after birth the temperature had reached constant values with low HDR. There was a negative correlation between the HDR and the temperature of the whole back area (p < 0.001). A positive correlation was found between the HDR within 30 minutes after birth and the PO2 of the umbilical arterial blood (p < 0.001). The data support the conclusion that nonshivering thermogenesis is initiated within minutes of birth and contributes to the elevation of body temperature. Furthermore, nonshivering thermogenesis after birth is reduced by low arterial PO2 at the time of birth.

Adult↗
PubMed1998

Physical activity and the risk of breast cancer: a case-control study of Japanese women.

A case-control study was conducted in Ibaraki, Japan. Cases were 148 women aged 26-69 diagnosed with breast cancer at Tsukuba University Hospital or Tsukuba Medical Center Hospital between January 1990 and March 1997. Two controls were individually matched to cases by age (within 1 year) and residence (municipalities). A self-administered questionnaire was used to obtain information on physical activity and the effects of potential confounding factors. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95 percent confidence intervals (95% CIs). After adjustment for potential confounding factors (height, body mass index (BMI), family history of breast cancer, education, age at menarche, age at first birth, parity, menopausal status), recreational physical activity was associated with a reduced risk of breast cancer (p for trend = 0.005). OR for breast cancer among women who played regular sport or exercise more than 15.3 METs per week was 0.35 (95% CI = 0.17, 0.73), as compared to women with no sport or exercise. The risk of breast cancer was also reduced in women with higher occupational physical activity levels, but it was not significant (p for trend = 0.223). The adjusted OR among the highest quartile level was 0.55 (95% CI = 0.27, 1.12) with the lowest quartile level as reference. Our findings support a protective effect of recreational physical activity on breast cancer in Japanese women.

Adult↗
PubMedDate not supplied

Reproductive performance in gilts through their first two parities.

Fertility data were collected for 766 gilts from 12 breeding and commercial herds. The age at first breeding was 244.5 days and at first farrowing 363.2 days. The litter size was 9.91 piglets born (9.16 live). The farrowing rate at the first service was 87.8%. The total farrowing rate was 95.5% of the mated gilts and 88.4% of all the gilts. 9.8% were repeat breeders. 2.6% of the once mated gilts never returned to oestrus and still did not farrow. The culling rate was 11.6%. The major reason for culling was delayed puberty/anoestrus (7.7%). Of the 565 gilts having a first litter 85.3% were mated after weaning. The age at second farrowing was 541.7 days. The litter size was 10.9 piglets born (10.3 live). The farrowing rate after first service was 83.0%. The total farrowing rate of the 482 sows was 92.9% and of the 565 weaned sows 79.3%. 12.2% were repeat breeders. 4.8% of the sows once mated never returned to oestrus and still did not farrow. The culling rate was 20.7%. Culling because of anoestrus was 4.4%. The month of birth significantly influenced the number of gilts culled because of anoestrus, the age at first breeding and at first and second farrowing. The season also influenced the interval from weaning to service, the percentage of sows served within 7 days of weaning and culled because of anoestrus. No correlation between a high ultrasonic index and lowered fertility was found. The age at first breeding was 1.12 days younger per unit higher ultra-sonic index.

Animals↗
PubMed1998

The risk for recurrence of premature births to African-American and white women.

Preterm birth rates are higher for African Americans than for whites, but the risk for recurrence is not well defined. We tested the hypothesis that the base and recurrence rates for premature births are higher for African Americans than for whites. We recruited a cohort of African-American and white women giving birth to singleton infants between 1988 and 1993 at Perinatal Network, a Midwest urban teaching hospital. These women had known reproductive history, delivered two or more singletons, and had no planned abortions, miscarriages, or induced preterm labor. Premature infants were born at less than 37 completed weeks of gestation. The total preterm birth rate among African Americans was 24.5%, significantly higher than the 11.1% for whites (relative risk, 2.22; confidence interval, 1.79 to 2.75). The preterm birth rate among African Americans for the second pregnancy was 30.6%, significantly higher than the rate of 18.2% for the first pregnancy and 24.5% for the third and fourth pregnancies. The preterm birth rates for whites were 11.7% for the first pregnancy, 9.8% for the second, and 12.9% for the third and fourth pregnancies, which were not significantly different from each other. Considering only the first two pregnancies, recurrence accounted for 32.6% of all premature births for both African Americans and whites. After the second pregnancy, 68% of African-American and 41.7% of white premature babies were born to women who had previous preterm infants. We conclude that preterm births are relatively common for African Americans and whites in the first two pregnancies. Women, particularly African-American women with a previous preterm birth at either the first or second pregnancy, require more specific management to prevent recurrence of preterm birth.

Birth Rate↗
PubMedDate not supplied

Increments in whole body bone mineral content associated with weight and length in pre-term and full-term infants during the first 6 months of life.

BACKGROUND: The objective of the present study was to assess bone mineral content (BMC) of the whole skeleton in pre-term and full-term healthy infants and the factors influencing BMC, such as bone area, birth weight, birth length, current weight, current length, gender, and gestational age. METHODS: Forty-eight healthy full-term infants and 34 healthy premature infants fed predominantly with intact human milk were studied. BMC was measured monthly with dual energy X-ray absorptiometry (DEXA). At the same time, length and weight were measured and registered. Pre-term infants were studied at 60-day intervals. RESULTS: For both full-term and pre-term infants, BMC increased during the first months of life. However, the values of pre-term infants never reached the values of full-term infants, even after correcting for age and weight. For both full-term and pre-term infants, BMC was significantly correlated at the second month with birth weight (r = 0.901), birth length (r = 0.860), gestational age (r = 0.803), bone area (r = 0.960), current weight (r = 0.920), and current length (r = 0.840, p <0.001 for all correlation coefficients). Multivariate analysis revealed that bone area was the most important factor in predicting BMC. CONCLUSIONS: Pre-term children have lower BMC than full-term children. The main factor explaining this apparent osteopenia is bone area. Pre-term children have a higher daily mineralization rate than full-term children, but this catch-up mineralization is not enough to reach BMC levels seen in full-term children.

Absorptiometry, Photon↗
PubMed1999

Lactation in relation to postmenopausal breast cancer.

A modest inverse association between lactation and breast cancer risk has most consistently been observed in premenopausal women, and certain breastfeeding patterns, such as prolonged duration and early age at first lactation, may be important determinants of risk. However, these associations have not generally been observed in relation to postmenopausal breast cancer. As part of a multicenter population-based case-control study, the authors examined postmenopausal breast cancer risk according to breastfeeding characteristics. Breast cancer patients aged 50-79 years were identified from statewide tumor registries in Massachusetts, New Hampshire, and Wisconsin from July 1992 through July 1995. Similarly aged control women were randomly selected from population lists. Information regarding lactation history and breast cancer risk factors was obtained through telephone interviews. This analysis included only data on parous postmenopausal women (3,633 cases and 3,790 controls). After adjustment for age, parity, age at first birth, and other breast cancer risk factors, breastfeeding for at least 2 weeks was associated with a slightly reduced risk of breast cancer in comparison with women who had never lactated (relative risk = 0.87, 95% confidence interval 0.78-0.96). There was only a modest suggestion that increasing cumulative duration of lactation was inversely associated with breast cancer risk; the relative risk for women who had breastfed for > or =24 months was 0.73 (95% confidence interval 0.56-0.94) (p-trend for duration = 0.10). Age at first lactation was not consistently associated with risk. Modest inverse associations appeared to persist even up to 50 years since first lactation. Use of hormones to suppress lactation was not associated with postmenopausal breast cancer, nor was inability to breastfeed related to risk. These results suggest that lactation may have a slight and perhaps long-lasting protective effect on postmenopausal breast cancer risk.

Age Factors↗
PubMed2005

Further analysis of the risk of adverse birth outcome after maternal use of fluoroquinolones.

In a database cohort study, the risk of adverse birth outcome in Danish women who redeemed a fluoroquinolone prescription during pregnancy was examined. Among 87 women who redeemed a fluoroquinolone prescription at any time during the pregnancy, the prevalence ratio of preterm birth was 1.4 (95% confidence interval (CI), 0.6-3.2), one woman had a stillbirth, and no children died during the perinatal period. Among 130 women who redeemed a prescription during the first trimester or 30 days before conception, the prevalence ratio of congenital malformation was 0.7 (95% CI, 0.3-2.0) and the prevalence ratio of bone malformations was 2.2 (95% CI, 0.7-6.7). Our study raises the concern that prenatal fluoroquinolone exposure may be associated with an increased risk of bone malformations.

Abnormalities, Drug-Induced↗
PubMed2003

Body size at birth and adulthood and the risk for germ-cell testicular cancer.

To assess the association between adult body size and germ-cell testicular cancer risk and to understand whether this association is independent from perinatal characteristics, a nested case-control study was conducted. Three hundred and seventy-one patients with testicular cancer, registered in the Swedish Cancer Registry between 1958 and 1996 and aged 20-54 years at diagnosis, and 1238 individually matched controls were identified. Information on adult body size at age 18 years was obtained for all subjects through the Military Service Conscription Register, whereas perinatal information was obtained through birth records at the subjects' respective maternity wards. Height was positively associated with testicular cancer risk, and the association persisted after taking into account perinatal characteristics. The adjusted odds ratio (OR) was 1.55 [95% confidence interval (CI), 1.10-2.17] for the third tertile of height as compared with the first. No association between the risk for testicular cancer and body mass index was found. Long duration of gestation was negatively associated with testicular cancer risk [OR = 0.64 (95% CI, 0.45-0.91), post-term compared with term], whereas high birth weight appeared to increase the risk [OR = 1.35 (95% CI, 0.99-1.85)]. In conclusion, adult height and perinatal factors acted independently, suggesting that both the fetal life and the childhood and adolescence periods are windows of susceptibility to exposures that influence the risk for testicular cancer.

Adult↗
PubMed2004

Multivariate threshold model analysis of clinical mastitis in multiparous norwegian dairy cattle.

A Bayesian multivariate threshold model was fitted to clinical mastitis (CM) records from 372,227 daughters of 2411 Norwegian Dairy Cattle (NRF) sires. All cases of veterinary-treated CM occurring from 30 d before first calving to culling or 300 d after third calving were included. Lactations were divided into 4 intervals: -30 to 0 d, 1 to 30 d, 31 to 120 d, and 121 to 300 d after calving. Within each interval, absence or presence of CM was scored as "0" or "1" based on the CM episodes. A 12-variate (3 lactations x 4 intervals) threshold model was used, assuming that CM was a different trait in each interval. Residuals were assumed correlated within lactation but independent between lactations. The model for liability to CM had interval-specific effects of month-year of calving, age at calving (first lactation), or calving interval (second and third lactations), herd-5-yr-period, sire of the cow, plus a residual. Posterior mean of heritability of liability to CM was 0.09 and 0.05 in the first and last intervals, respectively, and between 0.06 and 0.07 for other intervals. Posterior means of genetic correlations of liability to CM between intervals ranged from 0.24 (between intervals 1 and 12) to 0.73 (between intervals 1 and 2), suggesting interval-specific genetic control of resistance to mastitis. Residual correlations ranged from 0.08 to 0.17 for adjacent intervals, and between -0.01 and 0.03 for nonadjacent intervals. Trends of mean sire posterior means by birth year of daughters were used to assess genetic change. The 12 traits showed similar trends, with little or no genetic change from 1976 to 1986, and genetic improvement in resistance to mastitis thereafter. Annual genetic change was larger for intervals in first lactation when compared with second or third lactation. Within lactation, genetic change was larger for intervals early in lactation, and more so in the first lactation. This reflects that selection against mastitis in NRF has emphasized mainly CM in early first lactation, with favorable correlated selection responses in second and third lactations suggested.

Animals↗
PubMed1981

Low-birth-weight and congenital rubella syndrome: effect of gestational age at time of maternal rubella infection.

Birth weights of 42 full-term patients with congenital rubella syndrome were analyzed. All of these infants were products of pregnancies in which the exact dates of the maternal first day of last menstrual period and of the time of onset of the mothers' rubella rash were known. The range of time of maternal rubella associated with low-birth-weight was in the gestational age interval from 16 to 100 days. Low-birth-weight may have a relationship with time of maternal rubella rather than with the type of defects, i.e., cataract, heart disease, and deafness.

Female↗
PubMed2006

Body size, dairy consumption, puberty, and risk of testicular germ cell tumors.

The etiology of testicular germ cell tumors (TGCTs) is poorly understood, with cryptorchidism and family history being the only well-established risk factors. Body size, age at puberty, and dairy consumption, however, have been suggested to be related to TGCTs. To clarify the relation of these variables to TGCT risk and to one another, the authors analyzed data from 767 cases and 928 controls enrolled in the Servicemen's Testicular Tumor Environmental and Endocrine Determinants Study (2002-2005). Overall, increased height was significantly related to risk (odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.36, 2.45), though body mass index was not (OR = 1.06, 95% CI: 0.66, 1.69). There was no association with age at puberty, based on ages at first shaving (OR = 1.29, 95% CI: 0.96, 1.73), voice changing (OR = 0.97, 95% CI: 0.71, 1.32), and nocturnal emissions (OR = 1.00, 95% CI: 0.73, 1.37). Similarly, there was no relation with dairy consumption at any age between birth and 12th grade. These results suggest that height is a risk factor for TGCTs, but the relation is unlikely explained by childhood dairy consumption. As adult height is largely determined in the first 2 years of life, increased attention to events in this interval may help elucidate the etiology of TGCTs.

Adult↗
PubMed1992

Low birth weight in the central Canadian Arctic.

Birthing, health and prenatal records of 523 infants born between 1984 and 1988 in the central Canadian Arctic, were reviewed. The incidence of low birth weight (LBW) was 5.5%, which is lower than in many other populations. Principal indicators of risk were a previous history of a LBW infant, a short inter pregnancy interval, low weight at the time of the first prenatal visit and a weight gain of less than 200 gm/wk throughout pregnancy. Use of nicotine and alcohol may have been contributing factors. Although low, it is argued that the incidence could be further reduced through prepregnancy social and educational programs, as well as intensified prenatal care for those at risk.

Arctic Regions↗
PubMed2000

Pregnancy outcome after in utero exposure to itraconazole: a prospective cohort study.

OBJECTIVE: This study was undertaken to determine whether itraconazole use during the first trimester of pregnancy was associated with increased risks of major malformations, spontaneous abortions, premature deliveries, and neonatal complications. STUDY DESIGN: In a prospective cohort study pregnant women exposed to oral itraconazole were matched with control subjects not exposed to any known teratogens. Primary outcome was the rate of major malformations. Secondary outcomes were live birth rate, rates of spontaneous abortion and therapeutic abortion, gestational age at delivery, birth weight, and neonatal complications. RESULTS: A total of 229 women exposed to itraconazole were reported to the manufacturer, 198 of whom used the drug during the first trimester of pregnancy. The rate of major malformations in the study group (156 live births) was 3.2%, compared with 4.8% in the control group (187 live births; relative risk, 0.67; 95% confidence interval, 0. 23-1.95). The rate of any pregnancy loss was higher in the exposed group (relative risk, 1.75; 95% confidence interval, 1.47-2.09). Birth weight was lower in the itraconazole group, although that difference may not be clinically significant. Gestational age at birth, rate of preterm delivery, Apgar scores at 1 and 5 minutes, and neonatal complications were comparable between the groups. CONCLUSION: Our study supports the hypothesis that the use of itraconazole during pregnancy is safe. Further surveillance and reporting of pregnancy outcomes will help to support this conclusion.

Abortion, Spontaneous↗
PubMedDate not supplied

Risk of postpartum induced abortion in Finland: a register-based study.

CONTEXT: Half of Finnish abortion patients already have children, and one in 10 pregnancies ending in abortions started within 12 months of a birth. Thus, many women may not practice contraception effectively during the postpartum period. METHODS: Data from national registers were used to create ajoint data file on pregnancies occurring in Finland over the period 1987-1998. The abortion risk (the risk of a conception that leads to an induced abortion) and abortion ratio (the number of conceptions leading to abortions divided by the number leading to deliveries) were analyzed in follow-up periods after all live births to women younger than 45 (684,922), using hazard regression and logistic regression. RESULTS: Pregnancies starting within eight months postpartum were more likely to end in abortion than were those starting later. Within the first eight months, the shorter the interval to the next pregnancy, the more likely the pregnancy was to end in abortion. Abortion risk was higher 6-18 months postpartum than at later periods and was highest at 6-8 months postpartum, particularly among unmarried women and teenagers. Between 1987-1988 and 1995-1996, the abortion risk within the first eight months postpartum rose significantly among women aged 25-29 and 30-34 (relative risks, 1.5 and 1.2, respectively). The abortion risk and abortion ratio were higher among teenagers than among women in other age-groups. CONCLUSIONS: The findings are consistent with the hypothesis that contraceptive practice is less effective postpartum, suggesting room for improvement in postpartum contraceptive counseling in Finland.

Abortion, Induced↗