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PubMedDate not supplied

Age, pattern and symptoms of menopause among rural women of Lahore.

BACKGROUND: The occurrence and timing of reproduction-related events such as menarche, first birth and menopause play major roles in a woman's life. The age at final natural menstrual period is an important risk indicator for subsequent morbidity and mortality. However, the age of natural menopause and frequency of various menopausal symptoms differ in different societies. The concept of "local biologies" has been put forward to account for such inter-societal and intrasocietal differences. The present study was undertaken to explore the age at menopause and symptom complex associated with menopause. METHODS: The data for this cross-sectional study were collected from a geographically defined rural population of 28,419 individuals living in 20 villages situated about 30 KM outside Lahore. A systematic random sample of 130 women was drawn from those 1337 women, who had reached natural menopause. In-depth interviews were conducted in local dialect. RESULTS: The mean age at menopause was 49 +/- 3.6 years; the median being 50 years. The majority of women (22.3%) reached menopause at 50 years followed by 13.9%, who became menopausal at 49 years. In 66.2% cases, the onset of menopause was sudden. Among those, who had a gradual transition, the duration of climacteric ranged from 2 to 30 months. The symptoms associated with menopause were lethargy (65.4%), forgetfulness (57.7%), urinary symptoms (56.2%), agitation (50.8%), depression (38.5%), insomnia (38.5%) hot flushes (36.2%) and dysparunea (16.9%). CONCLUSIONS: The median age of menopause in our study is lower than that reported for Caucasian, Thai and Malaysian women; similar to figures from Africa and South America; but higher than that reported from Iran, Egypt, Turkey and UAE. The frequency of various symptoms was comparatively lower than observed among Caucasian populations. The data highlights the need for studying 'local biologies' and understanding the social and cultural basis of these differences.

Adult↗
PubMed2003

Association of pesticide exposure and risk of breast cancer mortality in Mississippi.

Breast cancer is the most common form of cancer among women in the United States. Established risk factors include advancing age, early menarche, late menopause, positive first relative, late age of first birth and socioeconomic status. Mississippi has a combination of risk factors making it suitable for studying the pathways of breast cancer etiology. The purpose of this study was to analyze pesticide exposure and the risk of breast cancer mortality. Data for this study consisted of secondary analyses of the Mississippi age-adjusted breast cancer mortality aggregated by period (1970-1994). The total number of acres planted during 1997-2000 for each Statistical Economic Area (SEA) and by type of crop was used as proxy measure for pesticide exposure. Analyses by SEA revealed potential evidence for an association between pesticide exposure and risk of breast cancer mortality in three areas: Greenville, Corinth and Yazoo. The total number of acres planted was positively and significantly associated with female breast cancer mortality rate, and these associations differed by race and type of crop. The strongest correlation was between breast cancer mortality rate for white women and rice crops planted in Yazoo (rho = 0.674, p < 0.030). Moderate correlations were found between African-American breast cancer mortality rates and total acres planted in Corinth (rho = 0.667, p < 0.049), catfish crops in Greenville (rho = 0.648, p < 0.031), and although not statistically significant (p < 0.066) also with total planted acres in Greenville (rho = 0.573). In conclusion, there are moderate statistically significant associations between number of acres of crops planted and the mortality rate from breast cancer in Mississippi. The association varies by state economic area, race and type of crop planted.

Black or African American↗
PubMed2003

Parity, reproductive factors, and the risk of pancreatic cancer in women.

Incidence rates for pancreatic cancer are consistently lower in women than in men. Previous studies suggest that reproductive factors, particularly parity, may reduce pancreatic cancer risk in women. We examined parity, breast feeding history, age at first birth, menstrual factors, and exogenous hormone use in relation to pancreatic cancer risk in a prospective cohort study of women. Information on parity and other reproductive factors was assessed by questionnaires in 1976 and updated biennially. Multivariate relative risks were adjusted for cigarette smoking, body mass index, diabetes, and height. During 22 years of follow-up (1976-1998), 115,474 women contributed 2.4 million years of person time, and 243 cases of pancreatic cancer were identified. Compared with nulliparous women, the relative risk of pancreatic cancer was 0.86 [95% confidence interval (CI), 0.55-1.36] for women with 1-2 births, 0.75 (95% CI, 0.48-1.17) for 3-4 births, and 0.58 (95% CI, 0.34-0.98) for those with >/=5 births after adjusting for other factors. An analysis for linear trend indicates a 10% reduction in risk for each birth (P(trend) = 0.008). Other reproductive factors and exogenous hormone use were not significantly related to pancreatic cancer risk. In this large prospective cohort of women, parity was associated significantly with a reduced risk of pancreatic cancer. Additional studies should examine the physiological or hormonal changes underlying pregnancy or childbirth that may explain this finding.

Adult↗
PubMed1992

An epidemiologic study of ovarian cancer. Part 1: Reproductive and social factors.

This study was undertaken to investigate the risk factors of ovarian cancer. A retrospective analysis was used in this study where 52 ovarian cancer cases and an equal number of a control group were obtained from the Western region of Saudi Arabia. Analysis of data showed that cases and controls did not significantly differ in any of the studied social factors, marital status, social class, and family history of cancer ovary. However, when reproductive factors were considered, the mean values of parity and number of abortions, but not age at first birth. Were found to differ significantly between cases and controls.

Female↗
PubMedDate not supplied

The association of diet, obesity, and breast cancer in Hawaii.

A case-control study of the association of dietary fat and animal protein consumption with breast cancer was conducted between 1975 and 1980 on Oahu, Hawaii. Data from this study were used to explore the relation of selected foods and the interaction of nutrients and foods with other factors, such as body size, age at menopause, and ethnicity on the risk for breast cancer. The sample included 272 postmenopausal breast cancer cases and 296 neighborhood controls. Study participants included Japanese and Caucasian women, aged 45 to 74, who were residents of Oahu. There was a suggestion of a positive-dose response relation (P < 0.01) between sausage consumption and the odds ratio for breast cancer. Significant odds ratios for breast cancer were also found for higher intakes (above the 50th percentile) of diary items, sausage, and all meats combined. The dose-response relation for nutrients and foods tended to be stronger among women with a high Benn's index (kg/cm1.5182) compared to women with a low Benn's index. In general, subjects with high dietary intakes of fat and animal protein who were in the upper 50th percentile of body size were at the greatest risk for breast cancer. However, there was no evidence for an interaction between the dietary variables and body size, ethnic group, age at menarche, age at menopause, or age at first birth that would affect the odds ratio for breast cancer. These data suggest that women with both a high intake of foods rich in fat and animal protein and with a large body size are at increased risk for breast cancer.

Aged↗
PubMed2003

[Breastfeeding. Conditioning factors].

OBJECTIVES: To know the prevalence of maternal breastfeeding over distinctive ages of a child's life, in our ward, and to analyze the factors which bear an influence on its start, duration and stop. MATERIAL AND METHODS: In our study, we included 549 newborns who were born in and released in good health from the Palamos Hospital between March 1999 and March 2000. We carried out telephone surveys upon release from the hospital and at ages of one, three and six months. We compiled 82 variable which we processed and analyzed on Microsoft Excel. We defined the value p < 0.05 as statistically significant. RESULTS: 90.71% of newborns breastfed upon hospital release, 78.4% at one month, 58.28% at three months, and 32.8% at six months; of the latter, 53.6% belonged to immigrant families and 29.3% to European families. 54.43% of mothers from the European families studied attended Maternal Education. 83.13% of mothers who breastfed their babies had made their decision to do so before conceiving their child. CONCLUSIONS: We consider the rate of breastfeeding mothers to be satisfactory. Its prevalence progressively decreases as the child gets older without any important changes in any period. These are factors related to a higher rate of breast-feeding: immigrant families, full term pregnancy, low educational level, Maternal Education attendance, first births, decision to breastfeed made before conception, not giving any supplements, perception of milk production before hospital release and no to use nipple-shields nor pacifiers. Hypogalactia and mothers return to work are the main reasons for stopping breastfeeding.

Adult↗
PubMed2003

Constraints and choices in mothers' employment careers: a consideration of Hakim's Preference Theory.

This paper provides an empirical examination of women's work histories following a first birth, their sex-role attitudes, and the relationship between attitudes and work history. In the light of these analyses, the aptness of Preference Theory as an explanation for the position of women in the British labour market is considered. Addressed in particular is Hakim's argument that the main determinant of women's heterogeneous employment patterns and work histories is heterogeneity in their preferences for differing combinations of family work and paid employment. Although support is found for Hakim's argument that employment careers are centrally important for only a minority of women, little evidence is adduced that it is preferences that distinguish the minority from the majority. The existence of a continuum of work-family preferences means that women with similar preferences (but differing capacities for overcoming constraints) will have very different labour market careers. Analysis of longitudinal data fails to support the central argument of Preference Theory that women in Britain and North America (countries where women live 'in the new scenario') have genuine, unconstrained choices about how they wish to live their lives. Instead, it is argued that a complete explanation of women's labour market choices after childbirth, and of the outcomes of those choices, depends as much on understanding the constraints that differentially affect women as it does on understanding their personal preferences.

Adult↗
PubMed2003

Relationship of mammographic parenchymal patterns to breast cancer risk factors and smoking in Alaska Native women.

The purpose is to determine breast cancer risk factors and correlates of mammographic parenchymal patterns among Alaska Native women. A retrospective review was performed of mammograms and mammogram records among 528 sequential screening mammogram examinations performed in Anchorage, Alaska. Mammogram density was classified by American College of Radiology (Breast Imaging Reporting and Data System) density patterns 1-4 (fat-->dense) and by percent density. Clinical data, including risk factors, ethnic group (Indian, Aleut, or Eskimo), and smoking status were obtained. Results were analyzed by univariate and multivariate analyses. Of 528 women, 164 were Indian, 155 were Aleut, and 209 were Eskimo. Mean age at first birth was lower and parity higher compared with published data in white women. Breast cancer risk factors were similar across ethnic groups. In multivariate analysis, patient age, parity, hormone replacement therapy, hysterectomy, and history of biopsy were associated, and smoking was not associated with density scores. Aleut and Indian women were less likely to have high-density mammograms than were Eskimo women (P = 0.0448). No significant differences were found between ethnic group for conventional breast cancer risk factors. Mammogram density was associated with age at screening, parity, hormone replacement therapy, hysterectomy, history of biopsy, and ethnicity but not smoking status. Eskimo women had higher mammogram density than Aleuts or Indians.

Adult↗
PubMed2003

Percutaneous coronary intervention for myocardial infarction during pregnancy: a new trend?

Recent studies report that American women are increasingly delaying their first births. While the proportion of births in older women has been increasing, there is also increased prevalence of cardiovascular risk factors and complications of pregnancy with increasing maternal age. We present 2 cases of acute myocardial infarction occurring during pregnancy. The mothers were both over 35 years old, and had significant risk factors for coronary disease. Both were found to have atherosclerotic coronary lesions, and were managed with coronary intervention with successful reperfusion. One woman successfully delivered a healthy infant at term. The other had a spontaneous abortion shortly after discharge from the hospital. Given current demographic trends, it is likely that such cases will be more commonly seen.

Adult↗
PubMedDate not supplied

[Preimplantation genetic diagnosis of monogenic diseases].

Preimplantation genetic diagnosis (PGD) is an alternative to prenatal diagnosis allowing the detection of genetic diseases on IVF embryos before their transfer into the uterus and before the pregnancy. The aim of this procedure is to obtain unaffected or carrier embryos in order to avoid the burden of termination of pregnancy after prenatal diagnosis for couples at risk of transmitting particularly severe genetic disorders to their offspring. For monogenic diseases, PGD is most often based on single blastomere amplification by polymerase chain reaction (PCR). More than a decade after the first births, the possibilities of diagnosis for monogenic diseases have considerably increased. As for molecular biology and conventional diagnosis, the technologies and strategies for PGD are continually improved, with for instance introduction of fluorescent PCR or multiplex amplification. In this review, we describe several approaches for PGD of monogenic diseases, followed by an overview of the French practice, particularly in our lab.

Chromosome Disorders↗
PubMed1992

The weathering hypothesis and the health of African-American women and infants: evidence and speculations.

Observed variation between populations in fertility-timing distributions has been thought to contribute to infant mortality differentials. This hypothesis is based, in part, on the belief that the 20s through early 30s constitute "prime" childbearing ages that are low-risk relative to younger or older ages. However, when stratified by racial identification over the predominant first child-bearing ages, maternal age patterns of neonatal mortality vary between groups. Unlike non-Hispanic white infants, African-American infants with teen mothers experience a survival advantage relative to infants whose mothers are older. The black-white infant mortality differential is larger at older maternal ages than at younger ages. While African Americans and non-Hispanic whites differ on which maternal ages are associated with the lowest risk of neonatal mortality, within each population, first births are most frequent at its lowest-risk maternal ages. As a possible explanation for racial variation in maternal age patterns of births and birth outcomes, the "weathering hypothesis" is proposed: namely, that the health of African-American women may begin to deteriorate in early adulthood as a physical consequence of cumulative socioeconomic disadvantage.

Adolescent↗
PubMed2004

Early motherhood and disruptive behaviour in the school-age child.

AIM: To determine the significance of young maternal age, family adversity and maternal behaviour during mother-toddler interaction in the prediction of child disruptive behaviour at age eight. METHODS: From an ongoing longitudinal study of infants at risk for later psychopathology (n = 362), 72 young mothers aged between 15 and 24 y (median 22 y) at first birth were compared with 197 primiparous older mothers ranging in age from 25 to 41 y (median 29 y). Family adversity at childbirth was assessed using a modified version of Rutter's Family Adversity Index (FAI) and measures of child disruptive behaviour at age eight were obtained using Achenbach's Teacher Report Form (TRF). An observational procedure was used to assess maternal behaviour during mother-child interaction at the age of 2 y. RESULTS: Young mothers encountered more adverse family characteristics and were more inadequate, restrictive and more negative during interaction with their toddlers. Their school-aged children showed higher scores on all disruptive behaviour scales of the TRF. Hierarchical regression analyses revealed that family adversity and maternal behaviour during toddler interaction could account for most of the association between early motherhood and child disruptive behaviour. CONCLUSION: The impact of young motherhood on child mental health is not confined to teenage mothers and is mainly attributed to psychosocial and interactional factors.

Adolescent↗
PubMed2004

[A case-control study on the risk of female breast cancer in Wuhan area].

OBJECTIVE: To investigate the risk factors of female breast cancer and its potential alteration in Wuhan area. METHODS: A case-control study was conducted on 213 cases with histopathological diagnosis and 430 matched controls, using conditional logistic regression analysis. RESULTS: 28 factors such as educational level, history of benign breast disease, age at menarche, age at menopausal, meat and well-done meat intake, soy bean food, fruit, lactation time, body mass index (BMI), juvenile chest X-ray, psychological factor, were associated with breast cancer risk in one-way variance model. Multivariate conditional logistic regression analysis in total significant factors and subgroups showed that the risk factors of breast cancer would include high level education, psychological trauma, history of benign breast disease later age at menopause, more years of menstrual and more years of menstrual before giving first birth, high BMI, well-done meat intake and smoked food. Factors as later menarche, lactate longer, soybean food, fruit, drink tea habit were protective factors for breast cancer. Further breakdown of data showed some difference between premenopausal and postmenopausal women. Risks in premenopausal women were associated with history of benign breast disease, age of menarche, soybean food intake, whereas risks in postmenopausal women were related to age of menopausal, BMI, waist-hip ratio and fruit intake. Both psychological traumatic and duration of lactation were common pre-and postmenopausal risk and protective factors. CONCLUSIONS: Dietary habit and endogenous estrogen exposure related factors played important roles on women breast cancer in Wuhan area.

Adult↗
PubMed2004

Risk factors for breast cancer associated with mammographic features in Singaporean chinese women.

BACKGROUND: Mammographic density has been found to be a strong risk factor for breast cancer and to be associated with age, body weight, parity, and menopausal status. Most studies to date have been carried out in Western populations. The purpose of the study described here was to determine in a cross-sectional study in a Singaporean Chinese population the demographic, menstrual, reproductive, and anthropometric factors that are associated with quantitative variations in age-adjusted percentage mammographic densities and to examine the association of these factors with the dense and nondense areas of the mammogram. METHOD: We used mammograms and questionnaire data collected from subjects in the Singapore Breast Screening Project. Women ages 45 to 69 years participated and 84% of those screened were Chinese. Mammograms were digitized and percentage density was measured and analyzed in relation to the questionnaire data. RESULTS: Percentage mammographic density was associated with several risk factors for breast cancer, most of them also associated, in opposite directions, with the dense and nondense components of the image. Percentage density was associated with age and weight (both negatively), height and age at first birth (both positively), and number of births and postmenopausal status (both negatively). Percentage density was weakly associated with a previous breast biopsy but was not associated with age at menarche or menopause, with use of hormones, or with a family history of breast cancer. CONCLUSION: Percentage mammographic density in Singaporean Chinese women has similar associations with risk factors for breast cancer to those seen in Caucasians.

Aged↗
PubMedDate not supplied

Premarital sexual activity and contraceptive use in Santiago, Chile.

The Santiago Young Adult Reproductive Health Survey was conducted in 1988 to examine the sexual behavior of and contraceptive use among young adults in Chile. The survey was based on multistage household probability samples of 865 women and 800 men aged 15-24 who were living in Santiago in 1988. Findings show that 35 percent of females and 65 percent of males had had premarital intercourse. Among those who had done so, the median age at first experience was 18.4 years for women and 16.4 years for men. Only 20 percent of females and 19 percent of males used contraceptives at first premarital intercourse. Use of contraceptives increased with age at the time of that event. Fertility data reveal that 70 percent of first births were premaritally conceived, and more than one-third of these were born prior to union. The high rates of premarital and unintended pregnancy among young women and the low prevalence of effective contraceptive use indicate a need for greater emphasis on sex education and family planning services directed at adolescents and unmarried young adults in Santiago.

Adolescent↗
PubMedDate not supplied

Comparing outcomes in a statewide program for adolescent mothers with outcomes in a national sample.

One-year outcomes for 1,004 participants in a statewide program for pregnant and parenting teenagers were compared with outcomes for 790 adolescent mothers included in the National Longitudinal Survey of Youth. The program group was substantially younger and included more black women and fewer married teenagers than the national sample. Controlling for these and other baseline differences revealed that program participants were significantly more likely than the national sample to be enrolled in school, to be employed and to have avoided a subsequent pregnancy 12 months later. Several baseline variables, including age at first birth, ethnicity, education and living arrangements, were also predictive of one-year outcomes.

Adolescent↗
PubMed2006

A successful strategy for Preimplantation Genetic Diagnosis of beta-thalassemia and simultaneous detection of Down's syndrome using multiplex fluorescent PCR.

OBJECTIVES: Preimplantation Genetic Diagnosis (PGD) is an alternative to prenatal diagnosis providing couples the chance to start a pregnancy with an unaffected fetus. The objective of the present study was to develop and apply quick, sensitive and accurate single cell PCR protocols for PGD of beta-thalassemia and Down's syndrome detection. MATERIAL AND METHOD: Two couples carrying beta-thalassemia codon41-42 mutation underwent routine IVF procedures. Embryo biopsy was performed on Day-3 post-fertilisation and single cell multiplex fluorescent PCR was employed for mutation analysis, contamination detection and diagnosis of trisomy 21 cases. RESULTS: Seventeen embryos were tested in two clinical PGD cycles. This resulted in the first birth following PGD for a single gene disorder in Thailand and South East Asia, confirmed by prenatal testing. Two embryos were shown to be affected by Down's syndrome. CONCLUSION: Successful strategy for PGD of beta-thalassemia and Down's syndrome detection using multiplex fluorescent PCR was introduced.

Adult↗
PubMed2007

Pancreatic cancer incidence in relation to female reproductive factors: Iowa Women's Health Study.

OBJECTIVE: Motivated by inconsistent literature, we evaluated the association between incident pancreatic cancer and reproductive characteristics. DESIGN: The Iowa Women's Health Study is a large prospective population-based cohort followed from 1986 to 2003. Reproductive information was self-reported. PARTICIPANTS: The study population comprised 37,459 women aged 55-69 years at baseline. Over 18 years, 228 incident pancreatic cancers were identified. RESULTS: In a multivariate-adjusted model there were no associations between incident pancreatic cancer and age at first birth, number of births, age at menarche, or use of hormones. There was a statistically significant inverse association between age at menopause and pancreatic cancer incidence. Compared to menopause less than 45 years, the hazard ratio of pancreatic cancer was 0.61 (95% CI, 0.40-0.94) for menopause at 45-49 years, 0.75 (95% CI, 0.51-1.09) for 50-54 years, and 0.35 (95% CI, 0.18-0.68) for menopause at 55 years or more (P trend=0.005). This association held after restricting the cohort to never smokers. The associations between pancreatic cancer and ages at natural and surgical menopause followed similar patterns. In a parallel fashion, risk of pancreatic cancer was decreased for women with intact ovaries compared to those who had oophorectomy: hazard ratio was 0.70 (95% CI, 0.50-0.99). CONCLUSIONS: Our results indicate that older age at menopause is associated with reduced pancreatic cancer risk, but further research is warranted.

Age Factors↗