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PubMed1991

Early discharge of mothers and infants following vaginal childbirth.

With the construction and implementation of the first birthing center in the Air Force, it became necessary to deviate from the traditional 3-day postpartum hospitalization. The purpose of this study is to evaluate that decision. Three hundred seventy-one vaginal deliveries were examined. The average postpartum stay was 1.6 days. There were two maternal readmissions; both had the onset of symptoms at greater than 3 days postpartum. There were no infant readmissions. In-patient questionnaires revealed only satisfaction from the puerperae. It is the authors' opinion that early discharge is safe, cost-effective, and should be considered for implementation where feasible.

Adolescent↗
PubMed1991

[A case-control study on risk factors of female hypertension in Tianjin City].

A pair matched case-control study was conducted in 301 pairs female patients with essential hypertension and their controls. The data was analysed by the multiple conditional Logistic regression. The results showed the risk factors associated with hypertension were: body weight (OR = 1.17, 95% CI: 1.12-1.23), the family history of hypertension (OR = 2.18, 95% CI: 1.49-3.21) the family income (OR = 0.73, 95% CI: 0.56-0.94), heart rate (OR = 2.30, 95% CI: 1.41-3.76). OR for the age of menarche was significantly different before and after being adjusted by body weight. There were no relationship between the age of menopause, the age of the first birth, parties, oral contraceptive use or smoking status and hypertension. The paper suggested that the difference of prevalence of hypertension in male and female over 45 years old cannot be explained by menopause or the factors on birth in women.

Adult↗
PubMed1991

[Risk factors in breast carcinoma].

A group of 992 breast cancer patients (risk group, R) was compared with a group of 482 patients hospitalized for non oncologic reasons and matched for age and year of hospitalization (comparison group, C). The findings confirm the following factors as risk factors for breast cancer: nulliparity (R 28.8%, C 17.5%, p less than 0.001), late first birth (over 34 years of age) (R 11.4%, C 5.1%, p less than 0.001), diabetes mellitus (R 7.0%, C 3.8%, p = 0.017), hypertension (R 25.7%, C 18.1%, p = 0.0016), alcohol (R 9.4%, C 5.9%, p = 0.03), positive family history (R 14.8%, V 5.3%, p less than 0.001) and breast surgery for benign disease (R 13%, C 7.5%, p = 0.002). Frequently mentioned risk factors such as early menarche and late menopause did not emerge as risk factors in our study. Cigarette smoking did not show a protective effect but even tended to be more frequent in the risk group. Multiparity (more than 2 births) was protective (R 22.1%, C 32.4%, p less than 0.001). The findings on hormonal replacement therapy (R 7.1%, V 17.0%, p less than 0.01) might have been influenced by a selection bias (hospitalization of patients in the comparison group because of complications of hormonal replacement therapy such as bleeding) and are thus not fully conclusive. It can at least be said that hormonal replacement therapy is not more frequent in the risk group.

Adult↗
PubMed1991

[Pregnancy and traffic accident. A case report].

The authors report the case of patient (second pregnancy, first birth) who had been involved in a traffic accident which occurred on October 5, 1989 after 7 months of pregnancy. The trauma was scored 2 on the international Overall Abbreviated Injury Scale. The impact was frontal and the patient driving and wearing her seatbelt. After being admitted to hospital on several occasions with metrorrhagia and uterine contractions, it was decided to carry out a cesarian and a baby was successfully removed. The child presented with angulation of the left fore-arm and skeletal X-ray, particularly of the arms, revealed a fracture line with a callous already formed.

Accidents, Traffic↗
PubMed1990

[A case-control study on endometrial carcinoma].

In order to study the risk factors associated with endometrial carcinoma, a case-control study conducted in the First Affiliated Hospital of Xian Medical University, from July 1984 to June 1988. Interviews with 102 cases and 102 matched controls were made. The authors analyzed the data, by using odds ratio, chi 2 test, chi 2 test for trend and logistic regression. The results indicated that risk factors related to endometrial carcinoma might be early menarche, low frequency of pregnancy, nulliparity or low parity and obesity. The factors of hypertension, diabetes, uterine curettage, fluoroscopy of pelvic cavity and mental trauma might also play a very important role in the pathogenesis of endometrial carcinoma. There was no association between endometrial carcinoma and oral contraceptives, age of first birth, sterilization, leiomyoma of uterus.

Case-Control Studies↗
PubMed1990

[Hospital epidemiology--a comparative case control study of breast and cervical cancers].

To promote the comprehensive measure of cancer prevention for future, a hospital-based epidemiological study on a large scale has started at the Aichi Cancer Center Hospital. As the first step of this study by using a common questionnaire, a simultaneous case-control study on the two cancers involving 175 cases with breast cancer, 56 cases with cervical cancer and 231 controls was conducted in 1988. Body weight was positively related to breast cancer only in older (50-69) patients. Young age at first birth (less than or equal to 23) increased the risk of cervical cancer (OR = 4.1). Active and passive smoking increased the risk of cervical cancer (OR = 2.6, 2.3) but only passive smoking increased the risk of older breast cancer (OR = 2.0). Frequent intakes of green vegetables and carrot decreased the risk of younger (30-49) breast cancer (OR = 0.5, 0.5) and cervical cancer (OR = 0.3, 0.5). Some other factors with positive and negative effects on these two cancers were identified in this case-control analysis.

Breast Neoplasms↗
PubMed1990

Association of change in body mass with breast cancer.

We examined the relation between maximal adult change in body mass and breast cancer in the Epidemiological Follow-up Study of the first National Health and Nutrition Examination Survey. A total of 5599 women ages 25 to 74 years at the baseline examination in 1971 to 1975 were analyzed. Adult body mass change was calculated from baseline interview questions on lowest and highest adult weights, ages at those weights, and adult height. The cohort was followed for a median of 10 years and yielded 101 cases of breast cancer. In a multivariate model adjusting for potential confounders (age, body mass, education, parity, age at first birth, menopausal status, calorie and alcohol intake, and physical activity) the relative risk estimates for the upper two tertiles of body mass gain were 1.7 (95% confidence interval, 0.9 to 3.4) and 2.5 (95% confidence interval, 1.2 to 5.4), respectively, in comparison to the lowest tertile of adult body mass gain. The relative risk estimate for those with a loss in body mass during adulthood was 1.3 (95% confidence interval, 0.7 to 2.6) in comparison to those in the lowest tertile of adult body mass gain. There was no association between body mass at the baseline examination and subsequent breast cancer. The results of this study suggest that gain in adult body mass is a predictor of breast cancer risk independent of adult body mass. These results also suggest that avoidance of marked weight gain during adult life may reduce the risk of breast cancer.

Alcohol Drinking↗
PubMedDate not supplied

Induced abortion: a world review, 1990.

The worldwide trend toward liberalization of abortion laws has continued in the last four years with changes in Canada, Czechoslovakia, Greece, Hungary, Romania, the Soviet Union and Vietnam. Forty percent of the world's population now lives in countries where induced abortion is permitted on request, and 25 percent lives where it is allowed only if the woman's life is in danger. In 1987, an estimated 26 to 31 million legal abortions and 10 to 22 million clandestine abortions were performed worldwide. Legal abortion rates ranged from a high of at least 112 abortions per 1,000 women of reproductive age in the Soviet Union to a low of five per 1,000 in the Netherlands. In recent years, abortion rates have been increasing in Czechoslovakia, England and Wales, New Zealand and Sweden and declining in China, France, Iceland, Italy, Japan and the Netherlands. In most Western European and English-speaking countries, about half of abortions are obtained by young, unmarried women seeking to delay a first birth, while in Eastern Europe and the developing countries, abortion is most common among married women with two or more children. Mortality from legal abortion averages 0.6 deaths per 100,000 procedures in developed countries with data. Abortion services are increasingly being provided outside of hospitals, and for those performed in hospitals, overnight stays are becoming less common. National health insurance covers abortions needed to preserve the health of a pregnant woman in all developed countries except the United States, where Medicaid and federal insurance programs do not cover abortion unless the woman's life is in danger.

Abortion, Induced↗
PubMedDate not supplied

A minority group and China's one-child policy: the case of the Koreans.

This report describes the participation in the one-child certificate program by Koreans living in China, using data from a household survey conducted in 1986 in Yanbian Korean Autonomous Prefecture, Jilin Province. Although the Koreans and all other minorities are exempt from China's strict one-child family policy, by pledging not to have more than one child they receive the one-child incentives. The total minority population in China is nearly 70 million and their combined population growth rate is much higher than that of the Han majority. The Korean minority, however, has had a growth rate lower than that of the Han. Nevertheless, the level of acceptance of the one-child certificate among Korean couples is only about 10 percent of those who currently have one child--one-fourth of the 1982 national figure. Life-table analysis indicates that fewer than 9 percent of Korean women would accept the certificate within a six-year period after their first birth. In the meantime, a second child would be born to 60 percent of the women. Among eight factors considered, three--place of residence, occupation of husband, and sex of the living child--significantly affected the rate of acceptance of the certificate, according to the hazards model.

Adult↗
PubMed1990

[Risk factors for breast cancer. Do epidemiologic findings provide a basis for primary prevention?].

In Norway, approximately one in every 13 women will develop breast cancer. Epidemiological studies show rather consistent results regarding associations with some risk factors. Lowest risk is found in women with many children, early first birth, late menarche and early menopause. Recent studies indicate that a full-term pregnancy, after a short-lasting adverse effect, results in a risk-reduction of lifelong duration. The authors review the present knowledge of these and other risk factors of possible importance in the etiology; lactation, diet, body weight, physical activity, use of oral contraceptives and hormone replacement therapy. Primary preventive measures may potentially lead to substantial reduction in risk of breast cancer. However, it is difficult to suggest any feasible intervention strategy which would have a high probability of reducing occurrence of breast cancer in the general population.

Adult↗
PubMed1989

[Risk of breast cancer].

The factors that influence the risk of breast cancer are vitally important when collecting information on woman particularly at risk from cancer for screening and for advisory care in breast clinics. On the basis of the experience gathered over the last 150 years (since Rigoni-Stern in 1842), these should be divided up into I. confirmed (carcinoma of the breast, mastopathy with cytological atypia, women whose mother and sisters already had breast cancer), II. probable (childlessness, late first birth, miscarriage, early menarche and late menopause, overweight, elevated socio-economic status), and III. improbable risk factors (paranchyma samples according to Wolfe, the contraceptive pill, nicotine, coffee, alcohol and drugs).

Breast Neoplasms↗
PubMed1989

Changes in completed family size and reproductive span in Anabaptist populations.

The Anabaptist Amish, Hutterite and Mennonite peoples trace their origins to the Reformation. Although they share certain beliefs, such as adult baptism and the separation of church and state, each group is culturally unique. The Hutterite and Amish are highly fertile and their populations exhibit stable rates of growth. These demographic characteristics reflect communal living among the Hutterites and labor intensive farming practices among the Amish. The Mennonites are the most receptive Anabaptist group to outside socioeconomic influences and provide a demographic contrast to the more conservative Amish and Hutterites. Demographic data collected during a study of aging in Mennonite population samples from Goessel and Meridian, Kansas, 1980, and Henderson, Nebraska, 1981, formed the basis of a cohort analysis in order to assess fertility change over time. Completed family size has decreased significantly in all three communities since 1870. Since the early 1900's the mean age of the mother at first birth has fluctuated but the mean age of mother at the birth of the last child is decreasing significantly for the communities of Goessel and Henderson, thus effectively shortening the reproductive span. The pattern is somewhat different for Meridian, the most conservative of the three communities.

Adolescent↗
PubMed1989

A case-control study of large bowel cancer and hormone exposure in women.

Several lines of evidence indicate a potential role for hormonal or reproductive factors in the subsequent development of large bowel cancer in women. To evaluate the relationship between hormone exposure and large bowel cancer a case-control study was carried out in 18 Illinois hospitals. Female cases, ages 45-74 (n = 90), and controls (n = 208) were identified from an ongoing large bowel cancer study. Data were obtained from medical records, personal interviews, and a subsequent mail survey with a questionnaire specific to hormone usage. Menopausal estrogen use was found to be protective with respect to the subsequent development of large bowel cancer with an odds ratio of 0.6 (95% CI, 0.33-0.99). This effect remained after controlling individually for age at diagnosis, ever pregnant (yes/no), parity, age at first birth, hysterectomy with documented oophorectomy, cholecystectomy, and appendectomy. Simultaneous adjustment, using logistic regression, for age at diagnosis, parity, hysterectomy, and cholecystectomy resulted in an adjusted odds ratio for menopausal estrogen use and large bowel cancer of 0.5 (95% CI, 0.27-0.90). Subsite analysis revealed the protective effect to be strongest for the rectal cancer cases. These data support the hypothesis that exogenous hormones may alter the risk of large bowel cancer in women.

Adenocarcinoma↗
PubMedDate not supplied

Alternative data sources in a case-control study of conjugated estrogens and cancer.

In a case-control study of the relationship of conjugated estrogen use to endometrial and breast cancer, we compared the availability and quality of information on risk factors from hospital charts and gynecologists' records. Of the women for whom an indication of Premarin use was recorded in either source, 19 percent would have been classified as nonusers by the hospital chart alone, a proportion that was similar for the breast (18 percent) and uterine (14 percent) cancer cases and controls (23 percent). However, for current use of Premarin, a higher proportion (28 percent) of users were identified solely through the gynecologists' records, and this proportion was even higher among controls (42 percent) than among either breast (18 percent) or uterine (15 percent) cancer cases. As a result, relative risk estimates varied according to the source of exposure date. Physicians' records also provided substantially more detail than hospital records on duration of Premarin use, especially for controls. Most demographic, medical, and reproductive variables were adequately available from the hospital charts alone. However, certain reproductive variables, such as age at first birth, presence or absence of ovaries, and age at menarche, were not adequately recorded in either source. These results suggest that gynecologists' records provide more accurate exposure data than hospital charts to determine current use of conjugated estrogens. Moreover, in the assessment of certain reproductive variables, the use of both these record-based sources may not be sufficient.

Adenocarcinoma↗
PubMed1986

Risk factors of multiple primary cancers in breast cancer patients.

To clarify risk factors of multiple primary cancers in breast cancer patients, a case-control analysis based on data from medical records was conducted at the Aichi Cancer Center Hospital. For each of a total of 115 multiple primary cancer patients affected by one or two other primary cancers after or concurrently with breast cancer, two patients with unilateral breast cancer were selected as controls by matching age, time of the operation for breast cancer, and survival period. Multiple primary cancer patients were then divided into two groups, 61 cases of bilateral breast cancer and 56 cases of other multiple primary cancers. Conditional multiple logistic regression analysis indicated that relatively heavy smoking (more than 10 cigarettes per day) decreased the risk of multiple primary cancers taken overall (relative risk (RR) = 0.23); overweight status elevated the risk of bilateral breast cancer (RR = 3.01); and greater than average height (RR = 2.20), history of gallstone or cholecystitis (RR = 6.29), and late first birth or nulliparous status (RR = 6.85) elevated the risk of other multiple primary cancers. The effects of weight and height were predominant in the postmenopausal women. As to family history, we could not obtain clear results, though history of cancer among siblings tended to increase the risk of multiple primary cancers (P less than 0.10) and family history of breast cancer was more frequent in patients with bilateral breast cancer (not significant).

Alcohol Drinking↗
PubMed1988

[Reproductive function of women and risk of the development of breast cancer].

The relationship between risk for breast cancer and certain factors of reproductive function was studied on a "case-control" basis. It was demonstrated that the traditional and well-known index of age at first birth cannot be considered a universal factor for all females who have borne different numbers of children. Indexes which take into account age at all births proved more reliable in evaluating risk of cancer in bi-, tri- and multiparae. Indexes of relative risk and the role of characteristics of reproductive function are discussed.

Adult↗
PubMed1988

Adolescent marriage and childbearing: the long-term economic outcome, Canada in the 1980s.

The purpose of this paper is to examine the long-term economic outcomes (education, labor force participation, occupation, and income) associated with female adolescent marriage and childbearing. The 1981 Canadian census is the data source for all women in Canada at age 30, controlling for age at marriage and at first birth. The data suggest that women at age 30 in Canada are in the best economic circumstances when they remain single or when they marry at age 20 or older and either remain childless or begin their childbearing at age 25 or older. The implications of these findings are discussed.

Adolescent↗
PubMed1986

Risk factors for estrogen receptor-rich and estrogen receptor-poor breast cancers.

A population-based case-control study was conducted in King County, WA, to investigate whether risk factors for estrogen receptor (ER)-rich and ER-poor breast cancers differ. Responses to interviews with 329 women with breast cancer who were between 25 and 54 years of age at the time of diagnosis were compared to responses of 332 women of similar age who were selected from female residents of King County by random digit dialing. Of the 329 interviewed cases, 143 had ER-rich tumors, 97 had ER-poor tumors, and 89 had tumors that were not assayed for receptors. The relative risks of ER-rich and ER-poor breast cancers were similar with respect to late menarche, single marital status, history of extended lactation, menopause before age 40, history of benign breast disease, positive family history of breast cancer, obesity, and history of oral contraceptive and noncontraceptive estrogen use. Late age at first full-term pregnancy was a risk factor for ER-rich breast cancer but not for ER-poor breast cancer. This finding suggests that different causal mechanisms operate for these two types of breast cancer and supports the hypothesis that an early first birth protects against breast cancer by reducing the level of ERs in the mammary epithelial cells from which carcinomas develop.

Adult↗