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Reproductive history and allergic rhinitis among 31145 Danish women.

BACKGROUND AND OBJECTIVE: A successful pregnancy is associated with a strong skewing of the immune system towards a Th2-type immune response. Because such a deviation is also the hallmark of allergic disease, it was investigated whether allergic rhinitis in women was associated with an increased likelihood of becoming pregnant and having a successful outcome of pregnancies. MATERIAL AND METHODS: Information on allergic rhinitis and reproductive history was obtained for 31145 pregnant women who participated in a national birth cohort study in Denmark during September 1997 to March 2000, and for whom complete information on siblings and place of residence and birth was available via the Civil Registration System. Data were analysed using logistic regression. RESULTS: Women who had previously been pregnant (OR = 0.91, 95% CI 0.85-0.98) or who had given birth previously (OR = 0.91, 95% CI 0.85-0.98) were less likely to report allergic rhinitis than others. The number of previous spontaneous abortions, gestational week of the first spontaneous abortion and fertility treatment were not associated with allergic rhinitis. Women who had waited less than a year to become pregnant more often had allergic rhinitis (OR = 1.18, 95% CI 1.06-1.32, P = 0.002) than women who had waited for more than a year. Early age at menarche was associated with an increased likelihood of allergic rhinitis (Ptrend = 0.003). CONCLUSIONS: Our findings did not support the hypothesis that an atopic genotype overall should be associated with an increased likelihood of successful outcome of pregnancies, but it might be associated with a decreased waiting time to pregnancy.

Abortion, Spontaneous↗

Galactose metabolism and reproductive history in women with type 1 neurofibromatosis.

To explore a possible relationship between neurofibromatosis and abnormalities of galactose metabolism, we examined the activity and characteristics of red cell galactokinase and galactose-1-phosphate uridyl transferase in 14 white women with type 1 neurofibromatosis and in 28 control women. Women with NF1 had a significantly lower activity of galactokinase and were more likely to have the 3-band pattern on electrophoresis of their transferase enzyme known as the Duarte variant. In addition, we found that women with NF1 were more likely to have reproductive histories suggestive of hypogonadism, including irregular menses, infertility, ovarian cysts, and early menopause. We conclude that abnormalities of galactose metabolism may be linked to abnormalities of both germ cell and neural crest development.

Adult↗

Environmental factors, reproductive history, and selective fertility in farmers' sibships.

In a national study of births to farmers in Norway, grain farming was associated with short gestational age (21-24 weeks). An impact of selective fertility and maternal heterogeneity on the association was suspected but could not be assessed further in a traditional birth-based design. Thus, analyses based on the mother as the observational unit were performed. A total of 45,969 farmers with a first birth in 1967-1981 were followed for subsequent births and perinatal mortality. A perinatal loss increased farmers' likelihood to continue to another pregnancy, but this selective fertility was less dominant than in the general population due to a higher baseline fertility. The effect of the mother's reproductive history on the grain farming-midpregnancy delivery association was analyzed in 59,338 farmers with more than one single birth in 1967-1991. A history of preterm birth (< 37 weeks) in previous or subsequent pregnancies both was an independent determinant of midpregnancy delivery and also increased the effect of grain exposure. Nongrain farmers with a history of only term births had 1.3 midpregnancy deliveries per 1,000 births; grain farmers with a history of only term births had 1.8 cases per 1,000 (odds ratio (OR) 1.4, 95% confidence interval (CI) 1.0-1.9); nongrain farmers with a history of preterm birth had 6.8 cases per 1,000 (OR 5.5, 95% CI 4.0-7.6), whereas grain farmers with a history of preterm birth had 13.7 cases per 1,000 (OR 11.0, 95% CI 7.7-15.9). Selective fertility had only a marginal impact on the association. The study demonstrates that a maternally based design can contribute in the assessment of joint effects of environmental and maternal factors.

Agriculture↗

A prospective study of reproductive history and exogenous estrogens on the risk of colorectal cancer in women.

Among 118,404 female registered nurses who responded to a mailed questionnaire and had no history of cancer in 1976, 191 colon cancers and 49 rectal cancers were diagnosed during 8 years of follow-up. We observed no material association between parity and colon cancer risk; women who bore four or more children had a risk similar to that of nulliparous women (age-adjusted RR = 1.1, 95% confidence limits (CL): 0.6, 1.9). No consistent patterns of colorectal cancer risk were associated with age at menarche or at first birth. Current or past use of oral contraceptives did not appreciably alter the risk of colorectal cancer; past use of postmenopausal estrogens was associated with a reduced risk of colorectal cancer (RR = 0.5, 95% CL: 0.3, 1.0). These and other data do not support any substantial effect of reproductive history or oral contraceptive use on the risk of large bowel cancer; however, the possible protective role of postmenopausal estrogen therapy merits further investigation.

Adult↗

Phenotypic differences in upper genital tract abnormalities and reproductive history in dizygotic twins exposed to diethylstilbestrol in utero. A case report.

Major phenotypic variations in reproductive function and upper genital tract abnormalities were found between 30-year-old dizygotic twins exposed in utero to diethylstilbestrol (DES). The women were exposed to maternal DES doses of 12.5-50.0 mg daily starting from the 12th gestational week as documented in the original antepartum obstetric office records. Twin A had primary involuntary infertility of over four years' duration associated with a severe DES uterine deformity on hysterosalpingography (HSG). A complete evaluation demonstrated all other infertility investigations to be normal. Twin B had two term pregnancies but a significant history of reproductive loss, including three miscarriages and one ectopic pregnancy. HSG demonstrated mild DES-induced changes. Cervical adenosis was observed only in the more severely affected twin.

Abnormalities, Drug-Induced↗

[Reproductive history, contraceptives and cigarette smoke as risk factors for cancer of the thyroid in women. Case-control study].

BACKGROUND: Evaluation of the influence of hormonal and reproductive factors and the role of cigarette smoking in the onset of thyroid carcinoma. METHODS: Comparison between a group of 78 female patients all living in the district of Lazio, operated for thyroid follicular or papillary carcinoma at the Third Clinical Surgery Dept., Policlinico Umberto I, Rome (Italy) from 1990 to 1997, and a group of 150 women free from neoplastic and/or hormonal pathology, recruited by the compilation of a questionnaire. RESULTS: Cigarette smoking can be associated with risk reduction of developing thyroid neoplasia. On the contrary, no risk variation has been associated with the number of normal pregnancies, with pregnancy interruption both spontaneous and voluntary and with anthropometric characteristics of the analysed individuals. The first pregnancy at very young age and the use of contraceptives seem to determine a risk increase of thyroid cancer, at the limit of statistical significance. CONCLUSIONS: The antiestrogenic action of cigarette smoking exerts a protective action for thyroid carcinomas. Spontaneous or volontary interruption of pregnancy did not show a significant effect as risk factor.

Adolescent↗

Potential independent factors of variability of biological status and reproductive history of Yucatecan women.

In this paper, we report the results of the application of principal component analysis (PCA) in a study of the human ecology of rural-to-urban migrantion in Yucatan, Mexico. Socioeconomic, reproductive and anthropometric data from 216 women 32 years of age or older, were obtained in 1989-1990. Seventeen socioeconomic, demographic and environmental properties of the families of such women, plus migrant status, were employed in a PCA, which yielded five independent factors, explaining 57.1% of the total variance of such properties. These factors were employed to made a multiple regression analysis on 19 anthropometric and 21 reproductive traits, age adjusted. According to the multiple regression of women's biological status to independent factors, we found that in better living conditions (Factor 3), women are heavier, taller, with more body surface and subcutaneous fat in the trunk and in the upper extremity, than in worse living conditions. Better educational level of wife and husband (Factor 2) is associated with lower number of pregnancies and alive born children, as well as less reproductive losses. Women living in families with higher income (Factor 4), have a younger age at the first pregnancy, older age at the last pregnancy, greater number of pregnancies, alive born children and alive offspring at the interview, and they experience less reproductive losses in relation to the number of pregnancies. This fact suggests that for the families in this sample, big families are a strategy to cope with poverty and uncertainty in employment and income. Our results are discussed against the reports in the literature.

Adult↗

Season of birth of breast cancer patients and its relation to patients' reproductive history in Tokyo, Japan.

Seasonal distribution of the birth dates of 405 pre-menopausal and 285 post-menopausal breast cancer patients was investigated in order to determine whether or not the season of their birth was related to various reproductive risk factors of breast cancer, including nulliparity, late age at first birth, early age at menarche, late age at menopause, and a history of benign breast diseases. The seasonal distributions of births were compared between groups of patients categorized according to whether they possessed each risk factor or not, separately for pre- and post-menopausal patients. Patients with the same menopausal status generally had the same seasonal distribution of births, irrespective of whether or not they possessed a risk factor. Moreover, low-risk patients exhibited more deviation in the seasonal distribution of birth from general births than the high-risk patients. These results suggest that the distinctive seasonal distribution of birth observed in breast cancer patients is basically a phenomenon independent from the effect of the reproductive history on the occurrence of breast cancer, and that specific seasonal factors are involved at the fetal or neonatal stage in the etiology of breast cancer.

Adult↗

Maternal reproductive history: a registry based comparison of previous pregnancy data derived from maternal recall and data obtained during the actual pregnancy.

OBJECTIVE: To compare the quality of data on previous pregnancies, based on maternal recall, to that of actual data in previous birth records, and to quantify to which extent recall based data bias results in epidemiologic studies on adverse reproductive outcomes. METHODS: Through linkage between agricultural censuses and the Medical Birth Registry, we identified 87,113 Norwegian female farmers with 174,764 single births in 1967-1991, including 533 late abortions (16-27 weeks). Data were linked into sibship records. In routine birth records, mothers provide information at each birth on previous fetal loss. Thus, we had information both based on recall and on the actual record. RESULTS: Among all mothers with a loss documented in previous records, 73.5% had a recall of previous loss (sensitivity), while 74.3% of all mothers reporting a previous loss also had a loss in previous sibship records (positive predictive value). Late abortion after a previous loss according to the sibship record was more frequent than after a previous loss based on maternal recall (18.3 vs. 10.8 per 1,000). There was a particular lack of recall for previous losses of short gestational age or when the current birth was a late abortion; both conditions tended to deflate the association between a previous and a current adverse outcome. Grain farming was associated with late abortion in mothers with previous loss in sibship records (odds ratio, 2.6) but not among mothers without previous loss (odds ratio, 1.0). When information on previous loss was based on maternal recall the odds ratios were 1.4 and 1.3, respectively. CONCLUSIONS: Consecutive sibship records give more valid information than data derived from maternal recall.

Abortion, Spontaneous↗

Starting, spacing and stopping in the reproductive histories of outer Hebridean families.

Maternal ages at the first maternity (starting), at the last maternity (stopping) and the lengths of intervals between maternities (spacing) have been studied in the Outer Hebridean islands of Harris and Barra for births between the years of 1855 and 1990, a period during which a considerable 'fertility transition' occurred. There was a tendency in each island for increases with time in the ages at starting among less-fecund women (although after 1936 starting ages declined), and highly significant heterogeneity of covariance: adjusted means dependent on the total numbers of maternities experienced. The same result was seen for the ages at stopping. Lengths of reproductive life (the difference between ages at starting and stopping) rose to 1876-1895, and then fell, apart from a short-lived rise in Barra during 1956-1975, possibly due to the papal encyclical Humaneae Vitae. Intervals between marriage and first maternity and between successive maternities were studied by hazard function survival analysis. The marriage first birth interval remained very constant, unaffected by total maternities. The father's occupation and the mother's age at first maternity showed no significant relationships. In Barra there was a weak negative relationship with the date of the marriage. For intervals between maternities in both islands, total maternities and the death of a previous infant were associated with shorter, and birth order with longer intervals. In Harris, there were tendencies for intervals to be consistently long or short in families, and for the age of the mother and date at first maternity to be negatively related to the length of the interval. In Barra, a previous multiple birth was followed by a longer interval. The date of the previous maternity, father's occupation, maternal age at the previous maternity, the sex of the previous child, and the duration of the marriage appeared to have no influence on maternity intervals. Evidence for an effect of economic deprivation during the 19th century on the variables considered was equivocal. During the 20th century, it is suggested that economic depression during the inter-war years, the spread of contraception, and improvements in health care may have acted 'synergistically' to produce the lower ages of childbearing and the shortening of maternity intervals and reproductive lives.

Adolescent↗

Reproductive history and prognosis in patients with operable breast cancer.

BACKGROUND: Late menarche, early menopause, high parity, and early first birth decrease the risk of development of breast cancer. The influence of these factors on the survival of breast cancer patients has not been explained. METHODS: A group of 1885 patients with operable breast cancer was studied retrospectively. A univariate analysis was used to calculate 10-year overall survival (OS) and disease free survival (DFS) in relation to age, menopausal status, age at menarche and menopause, and number of pregnancies and deliveries. A multivariate analysis (Cox model) was performed in which classic prognostic factors (tumor size and grade, lymph node involvement) were included in addition to reproductive factors. RESULTS: Univariate analysis demonstrated better prognosis in patients who had never been pregnant compared with those who had (OS, 62% vs. 54%, respectively; P = 0.01; DFS, 53% vs. 44%, respectively; P = 0.005) and in nulliparous compared with parous patients (OS, 62% vs. 53%, respectively; P = 0.006; DFS, 52% vs. 44%, respectively; P = 0.004). Survival rates decreased with the number of pregnancies and deliveries. Patients with late menarche had worse survival then those whose first menstruation occurred before the age of 16 years (DFS, 47% vs. 41%, respectively; P = 0.04). By multivariate analysis, parity remained an independent prognostic indicator in addition to classic highly significant prognostic factors (nodal involvement, tumor grade and size). CONCLUSIONS: Results suggest that reproductive factors known to decrease the risk of breast cancer development have an adverse effect on prognosis.

Abortion, Spontaneous↗