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PubMed1998

Demographic implications of socioeconomic transition among the tribal populations of Manipur, India.

The demographic implications of socioeconomic transition are studied among the three subsistence categories of the Gangte, a little known tribe from northeast India. Reproductive histories of 444 ever-married women and other data on the 343 households from which these women were drawn were collected from 11 villages representing the 3 transitional groups. A trend of increasing household income and literacy of couples was observed from shifting cultivators to settled agriculturists to the town-dwelling Gangte. The effect of socioeconomic transition is also seen in the constriction at the base of the age-sex pyramid of the town dwellers compared with the other subsistence categories, suggesting a relatively lower proportion of children in the 0-5-year-old age group. Although exogamy is practiced among all the subsistence categories, a considerably higher percentage of admixture with non-Gangte is observed among the town dwellers compared with the others. Overall infant and child mortality among the Gangte is low. However, variation exists among the three subsistence groups in the sense that a considerable reduction is seen from the traditional shifting cultivators to the urbanized town dwellers, reflecting better socioeconomic conditions and greater awareness and accessibility of the town dwellers to public health amenities. No consistent or perceptible trend is evident in mean number of live births. The genetic implications of this demographic transition are reflected in Crow's indexes of selection.

Adolescent↗
PubMed1998

Predictors of low birthweight at the community level.

The outcome of pregnancy was studied in 148 women over a two year period in a rural area of Kenya as part of a prospective longitudinal study whose main objective was to study the functional effects of mild to moderate malnutrition. Data were collected on maternal anthropometric variables monthly, haemoglobin levels were determined by blood samples taken every six months, food intake was based on two days each month of actual weight and recall. Each woman's past reproductive history was established at the beginning of the study. Birth weight was taken and recorded within seventy two hours of delivery. Discriminant analysis was used to identify predictors of low birthweight. The analysis was based on 123 cases who had complete data on all the variables used in the equation. Of those included in the analysis, 14 women (11%) delivered low birthweight babies and 109 had normal birthweight babies. Results of the discriminant analysis showed that mid upper arm circumference (MUAC), body mass index (BMI), Blood haemoglobin levels (HB) and socioeconomic status (SES), are the best predictors of low birthweight. Ranked in order of relative contribution to birthweight they are BMI, HB, MUAC and SES. Low birthweight prevalence was determined as being 11.2 per cent. Eighty per cent of all known cases were correctly classified using the four variables. As a screening tool for low birthweight this model with four variables has 93% sensitivity, 78.4% specificity, 35.13% positive predictive value and 98.98% negative predictive value. The results suggest that it is possible to identify women at high risk for delivering low birthweight babies at the community level.

Anthropometry↗
PubMed1998

Ionizing radiation and cancer risk: evidence from epidemiology.

Epidemiological studies provide the primary data on the carcinogenic effects of radiation in humans. Much of what is known has come from studies of the atomic bomb survivors, and to a lesser extent from patients receiving radiotherapy. These studies demonstrate that exposure to moderate to high doses of radiation increases the risk of cancer in most organs. For all solid cancers combined, cancers of the thyroid, breast and lung, and leukemia, risk estimates are fairly precise, and associations have been found at relatively low doses (<0.2 Gy). Associations between radiation and cancers of the salivary glands, stomach, colon, bladder, ovary, central nervous system and skin have also been reported, but the relationships are not as well quantified. Associations between radiation and cancers of the liver and esophagus, and to a lesser extent multiple myeloma and non-Hodgkin's lymphoma, have been reported in a few studies, but results are inconsistent. Chronic lymphocytic leukemia, Hodgkin's disease, and cancers of the pancreas, prostate, testis and cervix have rarely been linked to radiation exposure. A linear no-threshold model adequately describes the dose-response relationship for solid cancers, although at extremely high doses the risk appears to flatten out. Because few populations have been followed until the end of life, the temporal patterns of risk are not completely known. An increased risk, however, does continue for several decades. In contrast, radiation-related leukemias begin to occur shortly (2-3 years) after exposure and, at least in the A-bomb survivors, a linear-quadratic dose response seems to fit the data better than a pure linear model. Radiation does not act entirely in isolation. It can interact with other carcinogens, e.g. tobacco or chemotherapeutic agents, and with host factors such as age at exposure, gender or reproductive history. Interactions with medical interventions or with certain heritable mutations have also been suggested. While the studies of high-dose exposures are essential for understanding the overall biological consequences of radiation exposure, the public is more concerned about the long-term health effects from protracted exposures at low doses. Unfortunately, the inherent limitations of epidemiology make it extremely difficult to directly quantify health risks from these exposures. While most epidemiological data are compatible with linear extrapolations from exposures at high doses or high dose rates, they cannot entirely exclude other possibilities. As the field of epidemiology advances, understanding more about the health effects of prolonged and low-dose exposures will be the next challenge.

Case-Control Studies↗
PubMed1998

Body composition characteristics after menopause.

The effect of menstrual and reproductive history on body fat development after postmenopause was investigated in 278 healthy females aged between 44 and 67 years (x = 55.8 yrs). The absolute and relative amount of body fat was determined by means of dual energy x-ray absorptiometry. Significant associations between body fat after menopause and age at menarche, age at menopause, and average cycle length were observed. Furthermore the age at first as well as at last birth and the weight gain during pregnancies were related significantly with body fat after menopause. Overweight (BMI > 25.0) during postmenopause was significantly associated with an early menarche, a late menopause, an early first birth and a higher weight gain during pregnancies.

Absorptiometry, Photon↗
PubMed1990

Photoperiod history, melatonin, and reproductive responses of male Syrian hamsters.

The action of melatonin (MEL) in mediating photoperiodic history (PPH) effects among male Syrian hamsters was investigated. In Exp. 1, pineal intact males in LD 14:10 received daily injections of MEL (15 micrograms) or ethanol:saline vehicle (SAL) 1 h before lights off for 8 wk to generate two groups experiencing identical photoperiods but distinctly different MEL histories. Following the cessation of injections, males were transferred to either LD 12:12 or LD 8:16 for 8 wk to evaluate whether their reproductive response to the new photoperiod would be more influenced by prior PPH or prior MEL history; MEL history was the significant variable. LD 12:12 caused gradual recrudescence in hamsters that were gonadally regressed following MEL injections. In contrast, LD 12:12 caused gonadal regression in hamsters that had large testes following SAL injections. Exp. 2 evaluated whether PPH influences might be mediated by aftereffects on the period (tau) of the circadian pacemaker regulating many behavioral and physiological rhythms. Pineal intact hamsters were exposed to long or short T cycles consisting of an 8 h photoperiod, repeated every 24.67 h (long T) or 23.33 h (short T) to mimic the aftereffects generated by short or long photoperiods. After 5 wk in these T-cycle conditions, all males were transferred to LD 12:12 for 11 wk. The reproductive response to LD 12:12 was modestly influenced by T-cycle history, even though each T-cycle generated different patterns of entrainment to LD 12:12. These findings support the hypothesis that the response of the reproductive system of male hamsters to an intermediate-duration photoperiod depends upon the duration of nocturnal melatonin secretion associated with hamsters' previous PPH.

Analysis of Variance↗
PubMed1999

Reproductive factors, family history, occupation and risk of urogenital prolapse.

OBJECTIVE: We conducted a case-control study to analyze risk factors for urogenital prolapse requiring surgery. METHODS: Cases were 108 women with a diagnosis of II or III degree uterovaginal prolapse and/or third degree cystocele. Controls were 100 women admitted to the same hospitals as the cases, for acute, non-gynecological, non-neoplastic conditions. RESULTS: Occupation showed an association with urogenital prolapse: in comparison with professional/managerial women, housewives had an odds ratios (OR) of urogenital prolapse of 3.1 (95% confidence interval (CI), 1.6-8.8). Compared with nulliparae, parous women tended to have a higher risk of genital prolapse (OR 2.6, 95% CI 0.9-7.8). In comparison with women reporting no vaginal delivery, the ORs were 3.0 for women reporting one vaginal delivery (95% CI 1.0-9.5), and 4.5 (95% CI 1.6-13.1) for women with two or more vaginal deliveries. Forceps delivery and birthweight were not associated with risk of prolapse after taking into account the effect of number of vaginal deliveries. The risk of urogenital prolapse was higher in women with mother or sisters reporting the condition: the ORs were, respectively, 3.2 (95% CI 1.1-7.6) and 2.4 (95% CI 1.0-5.6) in comparison with women whose mother or sisters reported no prolapse. CONCLUSIONS: Our data support the clinical suggestion that parous women are at a higher risk of prolapse and the risk increases with number of vaginal deliveries. First-degree family history of prolapse seems to increase the risk of prolapse.

Adult↗
PubMed2003

The conference on reproductive behavior: a history.

The Society for Behavioral Neuroendocrinology was, in part, an outgrowth of the Conference on Reproductive Behavior, which was, in turn, an outgrowth of the West Coast Sex Meetings. In this article I trace the history of these organizations. The West Coast meetings provided an opportunity for free and informal exchange among west coast researchers studying sexual behavior. The 29 meetings of the Conference on Reproductive Behavior began with a similar format that evolved as success and growth forced numerous changes. With time, the meetings became more structured and more dependent on time limits, and added invited addresses, symposia, workshops, roundtables, posters, tours, and papers presented by abstract only. The administrative structure was kept as simple as possible. With changing times, these informal meetings eventually were superseded by the Society for Behavioral Neuroendocrinology.

Animals↗
PubMed2002

Reproductive and menstrual history and papillary thyroid cancer risk: the San Francisco Bay Area thyroid cancer study.

Thyroid cancer rates are three times higher in women than men during the period between puberty and menopause, suggesting that the etiology of thyroid cancer may be related to female sex hormones and reproductive function. However, the results from epidemiological studies have been mixed. To assess this hypothesis, data on menstrual history, pregnancy history, and exogenous hormone use were analyzed from a population-based, case-control study conducted in the San Francisco Bay Area. Of 817 incident thyroid cancer patients (cases), ages 20-74 years, who were diagnosed in 1992-1998 and 793 controls, identified by random-digit dialing and frequency matched to cases on age and race/ethnicity, 608 (74%) cases and 558 (70%) controls were interviewed. Of these cases, 544 were of papillary histology and included in the present analysis. Women who reported onset of menarche before age 12 or after age 14 were at about 50% increased risk for papillary thyroid cancer; however, this effect differed among age- and ethnic-specific subgroups. Among parous women younger than age 45, risk was elevated for several variables measuring recency of pregnancy. Risk was reduced for women who had ever used oral contraceptives [odds ratio (OR), 0.73; 95% confidence interval (CI), 0.52-0.97], but there was no trend with duration of use. Although it remains unclear how sex hormones influence thyroid carcinogenesis, these relationships warrant further investigation.

Adult↗
PubMed1996

Sexual assault history and women's reproductive and sexual health.

Associations of sexual assault history with reproductive and sexual symptoms were evaluated in 3419 women randomly selected from two communities. Sexual assault was associated with excessive menstrual bleeding, genital burning, and painful intercourse (whether or not attributable to disease or injury), medically explained missing two menstrual periods, and medically unexplained dysmenorrhea, menstrual irregularity, and lack of sexual pleasure. Physically violent assaults and those committed by strangers were most strongly related to reproductive symptoms. Multiple assaults, assaults accomplished by persuasion, spouse assault, and completed intercourse were most strongly related to sexual symptoms. Assault was occasionally associated more strongly with reproductive symptoms among women with lower income or less education, possibly because of economic stress or differences in assault circumstances. Associations with unexplained menstrual irregularity were strongest among African American women; ethnic differences in reported circumstances of assault appeared to account for these differences. Assault was associated with sexual indifference only among Latinas.

Americas↗
PubMed1995

Reduced birthweight and length in the offspring of females exposed to PCDFs, PCP, and lindane.

The objective of this study was to investigate a broad range of adverse health outcomes and their potential association to wood preservative used in daycare centers. This article focuses on reproductive effects. A sample of 221 exposed teachers was provided by the employer's liability insurers. A comparison group (n = 189) insured by the same two organizations was recruited from nonexposed daycare centers. In a face-to-face interview, job history and reproductive history of 398 female teachers were ascertained. Data on exposure were provided, including measurements on concentration of pentachlorophenol (PCP) and lindane in wood panels, and of PCP, lindane, polychlorinated dibenzo-p-dioxins and dibenzofurans in indoor air. An exposure matrix based on individual job history, independent exposure information from each center, and reproductive history was set up with regard to the vulnerable time windows for each pregnancy. Using this approach, 49 exposed and 507 nonexposed pregnancies were identified, including 32 exposed and 386 nonexposed live births. For subgroup analyses the observations were restricted to independent pregnancies, excluding multiple and consecutive births. The data were analyzed with linear regression techniques, taking confounders into account. The crude median difference between exposed and nonexposed was 175 g in birthweight and 2 cm in length. Controlling for confounders, the results show a significantly reduced but weight (p = 0.04) and length (p = 0.02) in exposed pregnancies, even after restricting the data to independent pregnancies and pregnancies for which data could be validated from the mother's health cards. These differences were not explained by differences in gestational age indicating that a toxic effect, which could cause small-for date newborns, might have affected the fetus.

Adult↗
PubMed2006

Maternal miscarriage history and risk of anencephaly.

Women with a history of reproductive loss may be at an increased risk of having an unfavourable outcome in subsequent pregnancies. Using data from a matched case-control study based on the record of the Epidemiological Surveillance System of Neural Tube Defects, we evaluated the association between history of maternal reproductive loss and the risk of anencephaly in three Mexican states. Mothers of 157 cases of anencephaly and 151 controls born during the period March 2000 to February 2001, were interviewed about their reproductive history and other additional factors, including socio-economic characteristics, prenatal care, use of tobacco and alcohol, presence of chronic diseases, acute illnesses and fever during the periconceptional period, and consumption of multivitamins and medicines during this period; mothers who reported no prior pregnancies were excluded from the analysis; 58 matched case-control pairs were used for the analysis. After adjusting for potential confounders, women with a history of miscarriage in previous pregnancies had 4.58 times more risk of having a child with anencephaly, than those who did not have this history; OR = 4.58, [95% CI 1.22, 17.23]. Our results suggest that a history of previous miscarriages is a risk indicator for anencephaly in future gestations. This does not necessarily mean that the miscarriage itself is the cause, but that common mechanisms could be involved in the aetiology of both events. Thus, women who have had histories of reproductive losses, especially miscarriages, should be a priority group for the primary and secondary prevention of neural tube defects.

Abortion, Habitual↗
PubMed1991

Association of incident lung cancer with family history of female reproductive cancers: the Iowa Women's Health Study.

A number of studies have documented the familial aggregation of lung cancer; there is at least one report that female reproductive cancers are also increased in these families. To determine if the risk exists for all reproductive cancer sites, we conducted a nested case-control study of lung cancer incidence in a cohort of 41,837 women ages 55-69 years. Women were recruited by mail and asked to provide information on education, occupation, smoking habits, physical activity, and family history of specific cancer sites among female relatives. Four year follow-up for cancer incidence was conducted using a state-wide tumor registry. Compared to random controls (n = 1900), cases (n = 152) were more likely to have reported at baseline a sister affected with cancer of the uterus [crude odds ratio (OR) = 3.4, 95% Cl = 1.7-7.0, P less than 0.01], cervix (OR = 3.2, 95% Cl 1.2-8.6, P less than 0.05), or cancer at any site (OR = 1.6, 95% Cl 1.1-2.4, P less than 0.05). A family history of an affected mother with a female reproductive cancer was also more common among the cases, but not statistically significant. Cases were less educated, more likely to work in a technical/industrial setting, less physically active, more likely to smoke, and to smoke for a longer period of time than the controls (all P less than 0.01). These differences reduced the magnitude of the family history risk indicators; only the combined category of reproductive cancer at all sites among sisters remained statistically significant. Additional family studies should be done to assess environmental factors in the relatives of the cases and controls to disentangle the influence of shared genes and shared environmental factors in these associations.

Aged↗
PubMed2001

Reproductive ecology and life history of the human male.

Until recently, the reproductive ecology of human males has not been extensively investigated, primarily as a result of the need for a theoretical framework based on the reproductive constraints and energetics of mammalian males. More specifically, male reproductive ecology has necessitated an integrative interpretation of clinical and anthropological data based on the premise that the evolution of human male life histories has involved selection for physiological mechanisms aimed at optimizing trade-offs between survivorship and reproductive effort. This paper attempts to address this gap in our understanding by presenting the current state of male reproductive ecology, including physiologic data from clinical and anthropological investigations as well as recent theoretical developments. Recent investigations outlining population variation in reproductive endocrine function are discussed within the context of potential sources of variation, including energetic expediture, caloric intake, and developmental canalization during adolescence. Additional summaries of male senescence and behavior are presented to provide a complete overview of male life history. Implications of recent anthropological data on contemporary health issues such as prostate cancer and the development of a male contraceptive are also discussed. Finally, several theories are presented that may contribute to our understanding of the evolution of male life histories and reproductive ecology, including theoretical suggestions involving the role of competition, mate choosiness, and potential constraints on male insemination ability, as well as a theory suggesting that male reproductive ecology may be best understood by analyzing energetic allocation decisions between differing somatic tissues that may be indicative of the competing needs for optimizing survivorship and reproductive effort. Directions for future research are finally considered.

Aging↗
PubMed1994

Options in making use of pregnancy history in planning and analysing studies of reproductive failure.

BACKGROUND: Although more epidemiological studies of reproductive health have been published recently, important scientific achievements remain few. Among the reasons for this are existing methodological constraints. Fertility is low in most parts of the industralized world, making the observation time short. Pregnancy itself is under extremely close medical surveillance with intensive health care interventions such as prenatal screening, induced abortions, induced labour, and prescribed changes in environmental exposures, but the epidemiologists are generally left with cause-effect experiences which escaped medical attention or study of diseases for which there is no cure. The main problem in non-experimental research of reproductive failure, however, is the most pregnancies are planned and past pregnancy experience is used in the planning. Self selection into different exposure categories according to past pregnancy experience should therefore be considered when studies are designed and analysed. STUDY OBJECTIVE: To consider how to deal with past pregnancy experience as an indicator "background" risk of reproductive failure. The present standard is to take parity or gravidity into consideration but this may be of little value and could even be very misleading. MAIN RESULTS: No simple and universal analytic strategy is available in reproductive epidemiology. On some occasions studies should be restricted to the first pregnancy only, in other situations the past reproductive experience may be used to form groups that are comparable in terms of pre-exposure risk.

Birth Order↗