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PubMed2004

[Factors associated with precarious prenatal care in a sample of post-partum adolescent mothers in maternity hospitals in Rio de Janeiro, Brazil, 1999-2000].

This study characterizes the women receiving precarious prenatal care according to socio-demographic variables, mother's reproductive history, family support, satisfaction with pregnancy, and risk behavior during pregnancy. A total of 1,967 adolescents were interviewed in the immediate post-partum in public and outsourced maternity hospitals in the City of Rio de Janeiro. The dependent variable was the number of prenatal appointments (0-3; 4-6; 7 or more). The statistical analysis aimed to test the hypothesis of homogeneity of proportions, including bi- and multivariate analysis, using multinomial logistic regression, in which the reference category for the response variable was 7 or more prenatal visits. Higher (and statistically significant) proportions of insufficient number of prenatal visits (0-3) were associated with: precarious sanitation conditions; not living with the child's father; attempted abortion; and smoking, drinking, and/or drug use during pregnancy. The results strongly indicate that mothers with worse living conditions and risk behavior during pregnancy were the same who lacked access to prenatal care.

Adolescent↗
PubMed2001

Analysis of specific adaptation to a domicile habitat: a comparative study of two closely related cockroach species.

The German cockroach, Blattella germanica (L.), and the closely related species B. bisignata (Brunner) belong to the germanica species group. They are similar in appearance, life history, reproductive cycle, and courtship behavior. The most significant difference is habitat preferences: B. germanica is a household species and lives in crowded conditions, whereas the feral B. bisignata lives outdoors in a solitary manner. Nevertheless, B. bisignata has recently been found in households. A comparison between the two species has shown that B. germanica displays gregarious behavior and produces an aggregation pheromone, whereas both characters are absent in B. bisignata. Mate preference experiments have revealed that B. germanica females accepted only conspecific males, whereas B. bisignata females mated with males from both species, provided that long distance calling was bypassed. In addition, the high reproductive potential of B. germanica outcompeted the other species: when 10 pairs of B. germanica and of B. bisignata were kept together in crowded conditions during 3 mo, B. bisignata was driven into extinction. It is concluded that the chances of B. bisignata becoming a new household species are remote.

Adaptation, Physiological↗
PubMed1988

Non-contraceptive estrogen use and the risk of gallstone disease in women.

We interviewed 102 women, ages 41-74 years who underwent gallstone surgery between January 1979 and September 1980, and 98 controls selected from the membership files of a large prepaid health care plan in Western Washington, about their past use of certain medications, reproductive history, and physical and demographic characteristics. The risk of gallstone disease among women who used estrogens for at least one year prior to diagnosis of their condition, relative to that of other women, was 1.18 (95% CI: 0.65-2.13). Standardization for the effects of age, race, obesity, parity, thiazide use, and history of high blood pressure did not alter appreciably the estimate of relative risk. Among estrogen users, the duration of use was similar in cases and controls. Our findings suggest that if non-contraceptive estrogen use is a risk factor for gallstone disease (requiring surgery) in women, its effect is very small.

Adult↗
PubMed1992

Pregnancy-induced hypertension in North Carolina, 1988 and 1989.

INTRODUCTION: Pregnancy-induced hypertension (PIH) is a highly prevalent pregnancy complication with adverse effects on maternal and infant health. Epidemiologic research concerning its etiology is limited. METHODS: Birth records from North Carolina for the period 1988 through 1989 included an indication of the presence of PIH. The risk of PIH was examined in relation to several maternal characteristics and exposures, including reproductive history, demographic characteristics, and tobacco use during pregnancy. Risk ratio estimates, adjusted for confounders, were calculated contrasting PIH among exposed vs unexposed women. RESULTS: The overall risk of PIH was 43.1 per 1000 births, with multiple pregnancies, nulliparity, and advanced maternal age associated with markedly increased risks. Tobacco use was inversely associated with PIH, and Blacks and Whites were at virtually equal risk. CONCLUSIONS: Problems in diagnosis and classification impede research in this area, with birth certificates limited in quality and breadth of information. Nonetheless, several patterns emerged that are worthy of further epidemiologic evaluation using more sophisticated designs.

Adult↗
PubMed1992

Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.

BACKGROUND: Most US medical records lack socioeconomic data, hindering studies of social gradients in health and ascertainment of whether study samples are representative of the general population. This study assessed the validity of a census-based approach in addressing these problems. METHODS: Socioeconomic data from 1980 census tracts and block groups were matched to the 1985 membership records of a large prepaid health plan (n = 1.9 million), with the link provided by each individual's residential address. Among a subset of 14,420 Black and White members, comparisons were made of the association of individual, census tract, and census block-group socioeconomic measures with hypertension, height, smoking, and reproductive history. RESULTS: Census-level and individual-level socioeconomic measures were similarly associated with the selected health outcomes. Census data permitted assessing response bias due to missing individual-level socioeconomic data and also contextual effects involving the interaction of individual- and neighborhood-level socioeconomic traits. On the basis of block-group characteristics, health plan members generally were representative of the total population; persons in impoverished neighborhoods, however, were underrepresented. CONCLUSIONS: This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records.

Adult↗
PubMed1993

Vietnamese infant and childhood mortality in relation to the Vietnam War.

OBJECTIVES: There is obvious potential for war to adversely affect infant and childhood mortality through direct trauma and disruption of the societal infrastructure. This study examined trends in Vietnam through the period of the war. METHODS: The 1988 Vietnam Demographic and Health Survey collected data on reproductive history and family planning from 4172 women aged 15 through 49 years in 12 selected provinces of Vietnam. The 13,137 births and 737 deaths to children younger than age 6 reported by the respondents were analyzed. RESULTS: For the country as a whole, infant and childhood mortality dropped by 30% to 80% from the prewar period to the wartime period and was stable thereafter. In provinces in which the war was most intense, mortality did not decline from the prewar period to the wartime period but declined after the war, consistent with an adverse effect during the wartime period. CONCLUSIONS: The data are limited by assignment of birth location on the basis of mother's current residence and by inadequate information on areas of war activity. Nonetheless, the data do not indicate a widespread, sizable adverse effect of the war on national infant and childhood mortality in Vietnam but suggest detrimental effects in selected provinces.

Adult↗
PubMed2000

The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993.

OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality.

Adolescent↗
PubMedDate not supplied

Effect of antioxidant intake on sperm chromatin stability in healthy nonsmoking men.

Oxidative stress is detrimental to sperm function and a significant factor in the etiology of male infertility. This report examines the association between dietary and supplementary intake of the antioxidants vitamin C, vitamin E, and beta-carotene and sperm chromatin integrity. Eighty-seven healthy male volunteers donated semen samples, completed food-frequency questionnaires, and provided information about their sociodemographic characteristics, medical and reproductive histories, and lifestyle habits. Sperm chromatin integrity was measured using the DNA fragmentation index (DFI) and related parameters, obtained from the sperm chromatin structure assay (SCSA). SCSA measures the susceptibility of sperm DNA to acid-induced denaturation in situ. After adjusting for age and duration of abstinence, there was no dose-response association between any DFI outcome and any antioxidant intake measure. Non-dose-related associations were found between beta-carotene intake and both the standard deviation of DFI (SD DFI) and the percent of immature sperm. Participants with moderate, but not high, beta-carotene intake had an increase in SD DFI compared with participants with low intake (adjusted means 206.7 and 180.5, respectively; P = .03), as well as an increase in the percentage of immature sperm (adjusted means 6.9% and 5.0%, respectively; P = .04). If antioxidant intake in the range studied is indeed beneficial for fertility in healthy men, it does not appear to be mediated through the integrity of sperm chromatin. The results of this study do not preclude possible beneficial effects of high antioxidant intake on sperm chromatin integrity for men with fertility problems.

Adult↗
PubMed2000

Catalase activity in equine semen.

OBJECTIVE: To characterize the activity of catalase in equine semen. ANIMALS: 15 stallions of known and unknown reproductive history. PROCEDURE: Seminal plasma was collected from raw equine semen by centrifugation, and samples of seminal plasma were frozen prior to assay for catalase activity. Tissue samples (n = 3 stallions) from the bulbourethral gland, prostate gland, vesicular gland, and testis were homogenized, and cauda epididymal fluid was collected for determination of catalase activity. Catalase activity was determined as an enzyme kinetic assay by the disappearance of H2O2 as measured by ultraviolet spectrophotometry. RESULTS: Catalase activity in equine seminal plasma was 989.3 +/- 1678 U/ml (mean +/- SEM), and the specific activity of catalase in equine seminal plasma was 98.7 +/- 29.2 U/mg of protein. Specific activity of catalase in tissue homogenates was significantly higher in the prostate gland (954 +/- 270 U/mg of protein) than in the ampulla (59 +/- 5 U/mg of protein), bulbourethral gland (54 +/- 11 U/mg of protein), vesicular gland (39 +/- 3 U/mg of protein), cauda epididymal fluid (11 +/- 3 U/mg protein), or testis (54 +/- 6 U/mg of protein). CONCLUSIONS AND CLINICAL RELEVANCE: Equine seminal plasma contains a high activity of catalase that is derived primarily from prostatic secretions. Procedures such as semen cryopreservation that remove most seminal plasma from semen may reduce the ability to scavenge H2O2 and thereby increase the susceptibility of spermatozoa to oxidative stress.

Amitrole↗
PubMed2000

Eclampsia in dogs: 31 cases (1995-1998).

OBJECTIVE: To compare clinical characteristics and laboratory findings of dogs with eclampsia with those of dogs without eclampsia. DESIGN: Retrospective study. ANIMALS: 31 dogs with eclampsia (affected) and 31 with dystocia (controls). PROCEDURE: Information on signalment, type of diet, reproductive history, litter size, time from whelping to eclampsia, body weight, clinical signs, results of physical examination and hematologic and biochemical analyses, response to calcium supplementation, and recurrence was obtained from the medical records of all dogs with eclampsia evaluated between 1995 and 1998 and compared with information from medical records of 31 of 102 dogs with dystocia evaluated during the same period. RESULTS: Dogs with eclampsia weighed less, had a smaller body weight-to-litter size ratio, higher rectal temperature and heart and respiratory rates, and lower plasma total solids concentration than control dogs. Ionized calcium concentration was < or = 0.8 mmol/L for all but 1 of the affected dogs; median concentration for the affected dogs was significantly less than that for control dogs. Six (19%) dogs did not manifest typical clinical signs associated with eclampsia. Twelve (39%) dogs with eclampsia had previous litters; none had a history of eclampsia. Affected dogs were discharged from the hospital within hours after admission, but 3 dogs returned 1 to 3 weeks later because of recurrence of eclampsia. CONCLUSIONS AND CLINICAL RELEVANCE: Eclampsia develops primarily in small-breed dogs with large litters. Plasma ionized calcium concentrations > 0.8 mmol/L in dogs with clinical signs typical of hypocalcemia may indicate that other causes of clinical signs should be considered. In addition, some dogs with eclampsia may have low ionized calcium concentrations and not manifest typical clinical signs.

Animals↗
PubMed1979

Fetal growth retardation associated with inadequate haemodilution in otherwise uncomplicated pregnancy.

The Hb level during pregnancy was followed in 113 non-anaemic women with uncomplicated pregnancy and birth weight of the baby above the 2.5th percentile. There was an inverse correlation close to statistical significance between the birth weight of the baby and the lowest Hb level reached during pregnancy as well as the Hb level in late pregnancy (38th week). A group of seven non-anaemic women with birth weight of the baby below the 2.5th percentile had a significantly higher (p less than 0.001) Hb level in late pregnancy than the normal group. Four of these cases had a statistically significant higher Hb level already in the second trimester. Trends in the reproductive history, complaints in the present pregnancy as well as results of hormone assays and the condition of the baby indicated that the seven cases represented a pathological group with fetal growth retardation. None of the women in the two groups were treated with diuretics. All had iron supplementation in high doses.

Adult↗
PubMed1997

Sick leave and social benefits during pregnancy--a Swedish-Norwegian comparison.

BACKGROUND: To analyze the correlation between sickness absence, working conditions, pregnancy outcomes and pregnancy associated social benefits in two urban pregnant populations in Sweden and Norway with different social benefit systems. METHODS: Relevant information on 1649 delivered women was manually extracted by the authors from the antenatal care and delivery records as well as from the personal social security files kept in the Värnamo and Hamar communities, and then computerized in a depersonalized form. RESULTS: The reproductive histories and the pregnancy outcomes appeared clinically similar in the two samples. Swedish pregnant women were significantly more often employed outside home (84 vs. 69 per cent). The types of occupations held were similar in Värnamo and Hamar. Swedish pregnant women were significantly more sick-listed during pregnancy than Norwegian women (64 vs. 32 per cent) and with a longer average duration of the sick-leave spells (61 days vs. 44 days). The sick-leave rate among Swedish employed pregnant women was 75 per cent as compared to 48 per cent in Norway. The differences appeared most evident in younger pregnant women (<25 years). The Swedish sick-leave rates were higher within all four occupational subgroups studied. During the observation period the pregnancy associated social benefits were significantly more generous in Sweden. CONCLUSIONS: Sickness absence during pregnancy does not seem to covariate in a simple way with ill health, working conditions or the amount of social benefits available. The increased sick-leave rates in Sweden may possibly be accounted for by a changing attitude towards pregnancy and its natural consequences, especially among younger women.

Adult↗
PubMed1997

The prevalence and severity of climacteric symptoms and the use of different treatment regimens in a Swedish population.

OBJECTIVES: To determine (i) the prevalence and severity of climacteric symptoms, and (ii) the prevalence of treatment for climacteric complaints, in a population based, random sample of Swedish women aged 46-62 years. MATERIAL AND METHODS: A random sample of 5990 women from the birth cohorts 1946, 1942, 1938, 1934 and 1930, resident in the city of Göteborg, was obtained from the population register. The women were invited by letter to complete a questionnaire concerning general health, reproductive history, climacteric symptoms (severity graded on a scale 0,1,2,3) and the treatment of climacteric complaints. The overall response rate was 76%. RESULTS: The prevalence of climacteric symptoms was as follows: vasomotor symptoms 53%, depression/irritability 57%, sleeping disturbance 52%, muscle/joint pain 57%, loss of libido 37% and vaginal dryness 21%. Hormone replacement therapy (HRT) with medium potency estrogens was currently being used by 13.4% and 7.7% were using low potency estrogens. Medium potency estrogens had previously been used by 14% and 6% had used low potency estrogens. HRT was reported to be effective against the most common climacteric complaints in 70%-90%. Non-hormonal treatment regimens had been used by 45% of the women and 31-63% reported a positive effect on climacteric symptoms. CONCLUSIONS: Although the majority of peri- and postmenopausal women reported suffering from climacteric complaints only 21% were current users of estrogens. Non-hormonal treatment modalities had been used by 45% of the women and were reported to have a good effect on climacteric symptoms in 45% compared to up to 90% of the HRT users.

Aged↗
PubMed1980

Ultrastructural and histochemical observations on the principal cells of monkey epididymis.

A correlative ultrastructural and histochemical study of the epididymal principal cells was carried out on six normal mature macaque monkeys with known reproductive histories. The outstanding cytologic feature of the principal cells was the abundance of infranuclear electron-dense granules (0.2-0.5 micronsm). These cellular inclusions are found in close proximity with large clusters of small mitochondria and to the subepithelial and periductular capillaries surrounding the basal epithelium. Histochemical tests revealed that these granules do not contain acid phosphatase, are not lipid, but do contain mucopolysaccharides and glycoprotein moieties. This intriguing morphological characteristic of the infranuclear region of the principal cells is similar throughout the entire length of the epididymis and appears to be unique in the monkey. The close relationship of these secretion type granules to mitochondria and their proximity to basal epithelial capillaries is in agreement with the concept of epididymal secretion and a possible endocrine function of the mammalian epididymis must be considered.

Acid Phosphatase↗
PubMed1980

Accuracy of predicting stages of bovine estrous cycle by gross appearance of the corpus luteum.

Four readily identifiable changes in appearance of corpora lutea (Stages I to IV) occur during a bovine estrous cycle. Accuracy of estimating the stage of an estrous cycle by appearance of corpora lutea was determined in a double-blind study. One investigator observed estrus in a group of heifers while another with no prior knowledge of reproductive histories of the heifers estimated stage of the estrous cycle by visual inspection of their corpora lutea. Stage of the estrous cycle (Stage I, days 1 to 4; Stage II, days 5 to 10; Stage III, days 11 to 17; Stage IV, days 18 to 20) was estimated correctly in 41 of 48 heifers. The correlation between estimated and actual days of the estrous cycle was .81. In addition, concentrations of progestins and weights of corpora lutea during estimated stages of the estrous cycle were similar to many other investigations. Stages of the estrous cycle in heifers can be estimated from appearance of corpora lutea.

Animals↗
PubMed1999

Fertility and reproduction in women with anorexia nervosa: a controlled study.

BACKGROUND: Women who have anorexia nervosa may experience difficulties with fertility and reproduction. METHOD: We examined fertility and reproductive history in 66 women who had a history of anorexia nervosa (DSM-III-R) and 98 randomly selected community controls as part of a follow-up investigation examining the course of anorexia nervosa. RESULTS: Although women with a history of anorexia nervosa and controls did not differ on rate of pregnancy, mean number of pregnancies per woman, or age at first pregnancy, women with anorexia nervosa had significantly more miscarriages and cesarean deliveries, and the offspring of women with anorexia nervosa were significantly more likely to be born prematurely and were of lower birth weight than offspring of controls. There were no differences between women with active versus remitted anorexia nervosa on any of these measures; however, offspring of anorexic women with no history of bulimia nervosa had significantly lower body weight than offspring of anorexic women with a lifetime history of bulimia nervosa. CONCLUSION: Our results argue for intensive prenatal care for women with both active and remitted anorexia nervosa to ensure adequate prenatal nutrition and fetal development.

Adult↗
PubMed2001

Two years maternal mortality in Matebeleland north Province, Zimbabwe.

OBJECTIVE: To describe timeliness and completeness of maternal mortality notifications after the introduction of a revised national notification form in 1998, as well as socio-demographic and obstetric variables and causes of maternal deaths. DESIGN: Retrospective descriptive study. SETTING: Seven districts in Matebeleland North province. SUBJECTS: 95 maternal death notifications from 1 August 1998 to 31 July 2000. MAIN OUTCOME MEASURES: Delay in submission and completeness of reports, age, marital status, religion, reproductive history, booking and referral status, duration and outcome of pregnancy, place of death, cause of death. RESULTS: 92/95 notifications were true maternal deaths, 86% were notified within 48 hours and 79% were complete, 74% of the deaths took place in a health facility. Mean age of the women was 27.8 years, mean parity 3.0. Sixty percent had booked. The five main causes of death were obstetric haemorrhage (26%), malaria (24%), immune deficiency syndrome (13%), abortion (11%) and eclampsia (8%). The maternal mortality ratio per 100,000 reported home and institutional live births ranged from 155 to 532 per district. CONCLUSION: There is under reporting of maternal mortality in some districts, although from 1997 to 2000 a 200% increase in reporting was seen. Timeliness and completeness of reporting was satisfactory. With the exception of a high contribution from malaria the causes of maternal mortality in Matebeleland North province are similar to those reported elsewhere in Zimbabwe.

Cause of Death↗
PubMed2003

Maternal mortality and associated near-misses among emergency intrapartum obstetric referrals in Mulago Hospital, Kampala, Uganda.

BACKGROUND: Many maternal deaths (as well as related severe morbidity) are of women who do not attend antenatal care in a given health unit but are referred there when they develop life-threatening obstetric complications. OBJECTIVE: To determine the reproductive characteristics of emergency obstetric referrals, and determine the contribution of emergency obstetric referrals to severe acute maternal morbidity (near-misses) and maternal mortality. STUDY DESIGN: Descriptive cross-sectional study. SETTING: Mulago hospital, the National Referral hospital, Kampala, Uganda, from 1st March to August 30th 2000. SUBJECTS: Nine hundred and eighty three consecutive women admitted as emergency obstetric referrals in labour or puerperium. INTERVENTIONS: Subjects were followed from time of admission to discharge (or death). They were interviewed (or examined) to obtain data on socio-demographic characteristics, reproductive history, obstetric outcome of the index pregnancy, obstetric complications and cause of death. Their records were reviewed to determine evidence of severe acute morbidity from acute organ/system dysfunction, using the definition by Mantel et al. These data were analysed using the Epilnfo computer programme in terms of means, frequencies and percentages. MAIN OUTCOME MEASURES: Socio-demographic characteristics, obstetric complications, cause of deaths, cause and type of near miss mortality and case fatality rates. RESULTS: Of the 983 referrals, over 100 were near-misses and 17 died. Using the definition of Mantel et al of near-misses enabled identification of six times as many near-misses as maternal deaths. The commonest causes of death were postpartum haemorrhage and eclampsia. Low status was highly associated with both maternal deaths and near misses. CONCLUSION: In developing countries, with poor obstetric services, emergency transfers in labour are very common. These women, who are of low status, contribute significantly to maternal mortality and morbidity.

Adult↗