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PubMed1990

[Reproductive variables and risk of benign breast diseases. A case-control study].

The purpose of the study was the identification of risk factors for benign breast diseases (BBD); 257 women with BBD diagnosed through pathological anatomy or cytology and a matched control for each were studied. Subjects were selected at The State University of Campinas Hospital and at a private clinic. To enter the study cases had to have a first diagnosis of BBD between October 1979 and August 1984. The following BBD were considered: dysplasia, fibroadenoma, cystic disease, papilloma and ductal ectasia. Reproductive variables were studied as risk factors, including menstrual ovulatory cycles. The date on which the BBD was diagnosed was defined as the index date. For controls, data were considered up to when they had reached the same age as the matched case on the occasion of her diagnosis. Nulliparity was a risk factor for BBD. First birth at or above age 30 was a protective factor. Women who had used contraceptive pills for two or more years had a significantly lower risk than those who had never used them. The number of menstrual ovulatory cycles was not found to be associated with the risk of BBD. The results obtained from the study of Brazilian women confirm some of the conclusions found in the literature, mainly those that associate some reproductive variables with the risk of BBD. A few of these variables are also confirmed as risk factors for breast cancer.

Brazil↗
PubMed2003

Combined effect of short stature and socioeconomic status on body mass index and weight gain during reproductive age in Brazilian women.

Short stature, a marker for undernutrition early in life, has been associated with obesity in Brazilian women, but not in men. We tested the hypothesis that weight gain during the reproductive years could explain this gender difference. A national two-stage household survey of mothers with one or more children under five years of age was conducted in Brazil in 1996. The subjects were women aged 20 to 45 years (N = 2297), with last delivery seven months or more prior to the interview. The regions of the country were divided into rural, North/Northeast (urban underdeveloped) and South/Southeast/Midwest (urban developed). The dependent variables were current body mass index (BMI) measured, BMI prior to childbearing (reported), and BMI change. Socioeconomic variables included mother's years of education and family purchasing power score. A secondary analysis was restricted to primiparous women. The prevalence of current overweight and overweight prior to childbearing (BMI > or = 25 kg/m2) was higher among shorter women (<1.50 m) compared to normal stature women only in the urban developed region (P < 0.05). After adjustment for socioeconomic variables, age, parity, BMI prior to childbearing, and age at first birth, current BMI was 2.39 units higher (P = 0.008) for short stature women living in the urban developed area compared with short stature women living in the urban underdeveloped area. For both multiparous and primiparous women, BMI gain compared to the value prior to childbearing was significantly higher among short stature women living in the urban developed region (P <= 0.04). These results provide clear evidence that short stature was associated with a higher BMI and with an increased risk of weight gain/retention with pregnancy in the developed areas of Brazil, but not in the underdeveloped ones.

Adult↗
PubMed2002

The encounter with family violence and risky sexual activity among young adolescent females.

In this article, we analyze the relationship between family violence and risky sexual activity for female adolescents (age 14 to 17). We examine two forms of family violence: experience (receiving physical abuse from a parent or parent-figure) and exposure (witnessing interparental physical violence). We hypothesize that either form of violence will predict greater odds of engaging in risky sexual behavior. We define risky sexual activity as any of the following: having multiple partners within the last 12 months or having sex with partners who are themselves engaging in risky behavior (e.g., having multiple partners of either sex, injecting unprescribed drugs, sharing unprescribed needles for injecting drugs). We analyzed data from 710 respondents taken from the National Survey of Family Growth, Cycle V, living with at least one biological parent. Results showed that experiencing violence from a parent greatly increased the likelihood of risky sex, even when controlling for the experience of forced sex, age, mother's age at first birth, race, socioeconomic status, and religiosity. Female adolescents who had experienced forced sex, those who were older (especially 17-year-olds), non-Hispanic Blacks (but not Hispanics), those living in a family with low educational attainment (less than a high school diploma), and those for whom religion was not or only somewhat personally important were more likely to report risky sex compared to others. These effects were not modified by whether the respondents lived in single- or two-parent families. An interaction between the two forms of physical violence suggests that either form is sufficient to increase significantly the odds of risky sex; an analysis in which respondents were differentiated by their experience of either form of violence showed a strong effect of experience on risky sex, net of the control variables.

Adolescent↗
PubMed1986

The effects of race, residence, and prenatal care on the relationship of maternal age to neonatal mortality.

This population-based study explores whether excessive neonatal mortality rates (NMRs) among infants with teenage mothers are attributable to young maternal age or to a translation of environmental disadvantage into reproductive disadvantage. First births from the 1976-79 linked birth and infant death registers for three states are analyzed. The data set is sufficiently large (305,907 births) to measure maternal age in fine gradations while including several control variables in logit analyses. The associations of racial identification and prenatal care with low birthweight, short gestation, and neonatal mortality overshadow and confound the association between teenage and poor outcome. At every maternal age, higher NMRs are observed for Blacks compared to Whites. The hypothesis that excessive neonatal mortality among Blacks is due to the greater frequency of teenage childbearing among Blacks is refuted. Indeed, unlike White, Black primiparae above age 23 experience higher NMRs than most Black or White teenagers. These results suggest that teenage maternity is not the primary causal agent of all of the problems with which it is associated.

Adolescent↗
PubMed1987

Factors affecting breastfeeding among women of Mexican origin or descent in Los Angeles.

Data on breastfeeding intentions and behavior were collected in prenatal and postpartum interviews as part of a study on first birth among 518 women of Mexican origin or descent in two Los Angeles hospitals. The prenatal intentions of 82 per cent of the women to breastfeed were maintained postpartum in one hospital but dropped sharply in the other. A greater number of hours a day with the baby in the hospital and earlier initiation of breastfeeding were associated with the hospital where prenatal breastfeeding intentions were more likely to be carried out. The intention to work postpartum was associated both with the decision not to breastfeed at all and with shorter intended duration of breastfeeding.

Adult↗
PubMed1995

Racial/ethnic differences in the likelihood of cesarean delivery, California.

OBJECTIVES: The purpose of this study was to determine whether women's sociodemographic characteristics are independently associated with cesarean delivery. METHODS: A retrospective review was conducted of hospital discharge data for singleton first births in California in 1991. RESULTS: After insurance and personal, community, medical, and hospital characteristics had been controlled, Blacks were 24% more likely to undergo cesarean delivery than Whites; only among low-birthweight and county hospital births were Blacks not at a significantly elevated risk. Among women who resided in substantially non-English-speaking communities, who delivered high-birthweight babies, or who gave birth at for-profit hospitals, cesarean delivery appeared to be more likely among non-Whites and was over 40% more likely among Blacks than among Whites. CONCLUSIONS: The findings cannot establish causation, but the significant racial/ethnic disparities in delivery mode, despite adjustment for social, economic, medical, and hospital factors, suggest inappropriate influences on clinical decision making that would not be addressed by changes in reimbursement. If practice variations among providers are involved, de facto racial differences in access to optimal care may be indicated. The role of provider and patient attitudes and expectations in the observed racial/ethnic differentials should also be explored.

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↗
PubMed1989

Intermodal enhancement of stimulus localisation in infants born prematurely.

The interaction of auditory and visual modalities in the enhancement of orientation was examined in premature and near-term infants by presenting them auditory or visual stimuli or auditory-visual stimulus combinations at various positions in sensory space. In 4.5--15-mo-olds, brisk orienting responses could be elicited to very peripheral stimulus positions but only when the stimulus consisted of a spatially coherent auditory-visual combination (i.e., where a sound and a light occurred at the same point in space). This occurred for all infants, irrespective of age or gestational age at birth. First, the result shows that infants can respond to visual stimuli at eccentric positions, beyond the supposed limits of their effective visual fields as measured by standard perimetry. Second, the result extends earlier studies showing that intersensory integration and stimulus localisation develop relatively normally in prematurely born infants. The auditory-visual enhancement test as used here may have a number of further uses and applications in the clinic and laboratory.

Arousal↗
PubMed2002

Alternative housing systems for pigs: influences on growth, composition, and pork quality.

Effects of pig birth (first 3-wk period) and rearing environments on growth and muscle quality characteristics of loins were evaluated in three experiments over seasons in west Texas and central Missouri. Housing systems included indoor slatted-floor buildings, indoor deep-bedded buildings, outdoor housing on dirt, and outdoor housing on alfalfa pasture. Experiments were conducted during the growing/finishing phases and pigs were slaughtered at the same age. Loins were collected, vacuum-packaged, and stored for 14 d at 2 degrees C. Pigs born and finished in an outdoor environment during the summer months (Exp. 1) had a greater ADG (0.92 vs 0.82+/-0.06 kg/d, P < 0.05) and had heavier carcass weights (87.9 vs 78.4+/-2.4 kg, P < 0.05) than pigs born and finished in an indoor environment with a slatted-floor finishing building. Carcasses from the outdoor-reared group measured a larger (P < 0.05) loineye area and were fatter (P < 0.01) at the first rib, last rib, and last lumbar vertebra measurements than carcasses from the indoor-reared group. Loin chops from outdoor-reared pigs had darker color scores in the retail display case throughout the 4-d period, measured lower L* values on d 1, and had more discoloration and browning on d 4 than loin chops from the indoor-reared group. During the winter months (Exp. 2), no difference was detected in ADG, carcass measurements, sensory characteristics, or shear force values from indoor-born pigs placed in either an outdoor or indoor finishing environment. Pigs finished on deep bedding (Exp. 3) had heavier carcass weights and more backfat (P < 0.01) than pigs finished on slats, but no differences were detected in sensory panel or shear force results. Overall, carcass measurements, pH, drip loss, sensory panel, and shear force values were similar among the groups finished in different housing systems. Outdoor or deep-bedded systems may increase growth rates of pigs if suitable land area and resources are available, but pork quality of loins will be similar for pigs finished in either conventional or alternative systems.

Animal Husbandry↗
PubMed1981

Effects of forced exercise during gestation on farrowing and weaning performance of swine.

Forty-three gilts and 24 sows were tethered throughout gestation, and one-half were forced to walk on a treadmill 15 min daily 5 days a week. Exercised and nonexercised dams farrowed 10.0 and 10.2 pigs (P greater than .05) and weaned 8.1 and 7.9 (P greater than .05), respectively. Birth weight of pigs born alive from exercised and nonexercised dams averaged 1.6 and 1.5 kg (P greater than .05); weaning weights were 8.5 and 8.2 kg (P greater than .05), respectively. Sows farrowed 12% more pigs (P less than .05) than gilts and weaned 17% more pigs (P less than .05) that were 12% heavier at birth (P less than .01) than those of gilts. Forced exercise did not improve (P greater than .05) reproductive performance as measured by numbers of pigs farrowed and weaned or by birth and weaning weights. Mean length of gestation was not significantly affected by age of dam or exercise treatment. The interval between birth of first and birth of last pig per litter averaged 154 and 151 min (P greater than .05) for exercised gilts and sows, respectively, and 170 and 161 min (P greater than .05) for those not exercised.

Animals↗
PubMed1984

Outcome of first delivery after 2nd trimester two-stage induced abortion. A controlled historical cohort study.

In a historical cohort study the outcome of the first birth after a legal 2nd trimester two-stage abortion induced with saline or prostaglandin F2 alpha was evaluated for 142 nulliparous and 65 parous women. The birth-outcome was compared with that for 180 parity-matched control women and for all women in Sweden 1975. No statistically significant differences were disclosed with regard to means of infants' birthweight and length of gestation, or to occurrence of low birthweight (LBW) infants and preterm deliveries. The nulliparous women with a previously induced abortion tended, however, to have more LBW-infants than did the other nulliparae . More LBW-infants were born to the 29 nulliparae with a previous abortion induced with prostaglandin than to the 113 nulliparae having abortions induced with saline (p = 0.11); otherwise no noteworthy differences were found in the birth-outcome for the 39 women with a previous abortion induced by prostaglandin, compared with the 168 having abortions induced by saline.

Abortion, Induced↗
PubMed1981

Bilateral carcinoma of the breast. Epidemiology and histopathology.

A history of previous carcinoma in the contralateral breast was found in 66 of 1351 women (5%) consecutively diagnosed as having breast carcinoma. The mean time interval between the diagnosis of the first and second tumour was 10.0 years (range 0-37 years); 63 of the tumours were metachronous. No significant differences were found between the first and the second carcinoma with respect to the Ackerman malignancy grading or the frequency of axillary node involvement. High risk groups for bilateral disease could not be defined on the basis of information about familial occurrence, parity, age at first birth, or malignancy grade.

Adult↗
PubMed1993

Melanoma and pregnancy. A review.

In the last half-century the incidence of cutaneous malignant melanoma has increased all over the world according to available reports. No association between risk of melanoma and age at menarche, first birth, menopause or duration of reproductive period has been proven so far. Studies on the effect of parity on relative risk and survival have given divergent results with multiparous women possibly having a better prognosis than nullipara. Women with melanoma diagnosed during pregnancy tend to have thicker tumours, shorter disease-free interval and, maybe, lower 10-year survival rate than non-pregnant matched controls. There is no conclusive evidence that therapeutic abortion improves the cure rate. Multivariate analysis has failed to unveil impaired prognosis in women who become pregnant subsequent to diagnosis.

Adolescent↗
PubMed1998

Scientific and ethical issues of preimplantation diagnosis.

Preimplantation diagnosis (PID) offers couples at high risk of having offspring affected with a genetic disorder the possibility of an early prenatal diagnosis. For many couples this approach will give the opportunity to avoid a selective termination of affected pregnancies. Substantial advances were made in PID since the report, in 1990, of the first birth obtained after PID. Yet, many technical hazards have to be solved for PID to become a standard clinical tool. The very close correlation existing between the forthcoming developments in the fields of PID and human genome mapping will improve the reliability and efficiency of genetic diagnosis. In the near future, the procedure may also become easier and safer. As a consequence, the indications for PID could be extended to other genetic defects, such as multifactorial diseases. They could also be extended to cases with no medical background, such as social gender selection or behavioural traits. In this perspective, it is now time for both the medical and scientific communities to identify the ethical issues related to these potential new indications.

Ethics, Medical↗
PubMedDate not supplied

Epidemiology of breast cancer in young women.

Breast cancer is a rare disease in young women, yet is the leading cause of cancer deaths in all ethnic groups in the United States and many parts of the world. The epidemiology for breast cancer in young women is reviewed, focusing on women under 40, prior to the recommended screening age. Specific age comparison groups used and results for young women vary in the literature, yet there are some common results. Young women have low incidence rates of breast cancer compared to older women. However, cancer incidence increases at a faster rate with increasing age in young women. Their cancers tend to be larger and higher grade with poorer prognostic characteristics, resulting in a higher risk of recurrence and death from breast cancer when compared to older women. Many of the usual risk factors for breast cancer in older women also increase risk in younger women including increasing age, Black race, family history, later age at first birth and menarche, radiation exposure and lack of physical activity. Risk factors that have specific relevance to young women include reproductive factors, history of induced abortion or miscarriage, oral contraceptive use, smoking, and radiation exposure, most specifically for treatment of Hodgkin Disease.

Adult↗
PubMedDate not supplied

The effect of pregnancy on survival in women with a history of breast cancer.

Nearly 25% of individuals diagnosed with breast cancer will be pre-menopausal women. As maternal age of first birth has risen in the United States, more females are being treated for breast cancer prior to child-bearing. Although surgery and radiation therapy appear to have no impact on future fertility, young women should be aware of the impact that systemic chemotherapy may have on ovarian function, as well as on future offspring. As regards survival, despite a link between female sex hormones and mammary carcinogenesis, the fear that pregnancy subsequent to breast cancer treatment would result in activation of dormant micrometastases has not been demonstrated in the literature. Published series have, in fact, shown either no impact on survival or a slightly protective effect when women deliver after breast cancer treatment. Although these studies are retrospective in nature and may be prone to selection bias and under-reporting of the true denominator, they can at a minimum be used to reassure women that a subsequent pregnancy is unlikely to have a negative impact on her survival.

Adult↗
PubMedDate not supplied

Lifetime reproductive and anthropometric risk factors for breast cancer in postmenopausal women.

Hormonally-linked adult reproductive and anthropometric risk factors have been well established in the etiology of postmenopausal breast cancer, though early life exposures have been evaluated only more recently. Here, we examine the evidence for associations between lifetime reproductive and anthropometric risk factors for postmenopausal breast cancer. The review finds some evidence for the hypothesis that breast cancer risk is determined by the number of susceptible stem cells, modified by the hormonal environment. The in utero experience of an infant may be associated with postmenopausal breast cancer; preeclampsia may decrease and greater birthweight increase risk, but more evidence is needed. Earlier and more rapid childhood growth appears to increase postmenopausal breast cancer risk and childhood obesity to decrease risk, but very few studies have yet examined these associations. Increased final height and earlier age at menarche are consistently associated with increased risk for postmenopausal breast cancer. Later age at first birth, decreased parity, later menopausal age, use of hormone replacement therapy (especially progestin containing), and increased postmenopausal adiposity are well-established risk factors for postmenopausal breast cancer. The effect of a woman's own pregnancy conditions and lactation are not established. Further investigation is needed to identify whether events occurring early in life modify later events or accumulate over the life course. Many aspects of this research can be conducted by examining the influence of early life events on intermediary events without the need for longitudinal data.

Aged↗
PubMed2004

Impact of child mortality and fertility preferences on fertility status in rural Ethiopia.

OBJECTIVES: To determine the effects of child mortality and fertility preference on fertility status in rural Ethiopia. DESIGN: Case-referent where the cases were women with number of children ever born alive was less than five and controls were women with number of children ever born alive greater or equal to five. SETTING: Butajira rural health project study base which is a field epidemiologic laboratory found 35 Kms south of the capital city of Ethiopia, Addis Ababa run by the Department of Community Health of Tikur Anbessa Medical Faculty. MAIN OUTCOME MEASURES: Fertility status measured by number of children ever born alive; death of a child or an infant is a predictor. SUBJECTS: A total of 219 women with number of children ever born alive less than five and 899 women with number of children ever born alive greater or equal to five were included in the study. RESULTS: Child mortality affected number of children ever born alive significantly (OR= 7.39, 95% CI: 4.62, 9.08). As the number of children died increased proportionally, there is a proportional increase in the risk of higher fertility (X2 for trend 4.92, d.f =4, p-value 0.02). Number of children desired before marriage, desire for more children and sex preference were not associated with increased fertility in this study. Of all the socio-demographic and reproductive variables, later age at first marriage and first birth showed lower number of children ever born alive with (OR= 1.82, 95 % CI: 1.24, 2.83) and (OR= 3.08, 95 % CI: 2.03, 4.68) respectively. Breast-feeding duration of more than six months showed association with less number of children ever born alive (OR= 1.92, 95% CI: 1.30,2.80). CONCLUSION: The study finding implies high fertility status is strongly associated with child death and hence measures that curb child mortality are believed to decrease fertility status besides promoting child survival.

Adult↗