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PubMedDate not supplied

Self-reported symptoms of gynecological morbidity and their treatment in south India.

This article presents an analysis of self-reported symptoms of gynecological problems among 3,600 recent mothers in Karnataka State, India. Approximately one-third of all women reported at least one current symptom; the most common were a feeling of weakness and tiredness (suggestive of anemia); menstrual disorders; white or colored vaginal discharge (suggestive of lower reproductive tract infection); and lower abdominal pain and discharge with fever (suggestive of acute pelvic inflammatory disease). Obstetric morbidity, associated with the last live birth, was strongly predictive of current gynecological symptoms. Women who delivered their last child in a private institution were significantly less likely to report symptoms than were those who delivered at home or in a government hospital. Nonusers or users of reversible contraceptive methods were also less likely to report symptoms of morbid conditions than were sterilized women. These associations persisted in analyses controlling for potentially confounding economic and demographic characteristics, and have far-reaching policy implications.

Adult↗
PubMed2004

The 2002 Canadian Contraception Study: part 1.

OBJECTIVES: To investigate the contraception and sexual health-related awareness, attitudes, and practices of a representative sample of Canadian women of childbearing age. METHODS: A self-report survey was mailed to a national sample of 3345 women, aged 15 to 44 years, who were members of a pre-recruited market research panel. Survey questions and methodology were similar to 3 previous Canadian Contraception Studies, allowing for description of current patterns of behaviours and beliefs and comparison of trends over time. RESULTS: Of 3345 women contacted, 1582 returned completed surveys, for a response rate of 47.3%. Responses were weighted to represent Canadian women by region, age, and marital status on the basis of current census data. Eighty-six percent of women sampled had ever had sexual intercourse and 78% were currently sexually active. Women's familiarity with oral contraceptives and condoms as methods of contraception was high (96% and 93%, respectively), but familiarity with other methods was much lower (sterilization, 62%; withdrawal, 59%; the morning-after pill, 57%; intrauterine devices, 50%; depot [injectable] medroxyprogesterone acetate, 38%). A very favourable opinion was held by 63% of respondents concerning oral contraceptives, by 38% concerning condoms, and by 39% and 28% concerning male and female sterilization, respectively. Among respondents who have ever had sexual intercourse, the most frequently used current methods were oral contraceptives (32%), condoms (21%), male sterilization (15%), female sterilization (8%), and withdrawal (6%). Nine percent of these respondents reported using no method of contraception at all. The currently reported rate of female sterilization is the lowest ever recorded in Canada. Survey results show that adherence to contraceptive methods is a challenge for many women and their partners, and that risk of sexually transmitted disease is an ongoing concern. CONCLUSION: This study provides a wide-ranging examination of contraception awareness, beliefs, and use among Canadian women that may provide guidance for clinical and public health practice. Part 1 of this report describes the methodology of the 2002 Canadian Contraception Study and the overall results of this study; Part 2 considers results pertaining specifically to adolescent women and women in their later reproductive years, reports on indicators of women's sexual function and reproductive health history, describes approaches to addressing challenges in contraception counselling, and presents data concerning trends in Canadian women's awareness and use of contraception over the past 2 decades.

Adolescent↗
PubMed1997

Gender and social differences in adolescent sexuality and reproduction in Nicaragua.

PURPOSE: The aim of this research was to study gender and social differences in adolescent sexuality and reproduction, as reflected in age at first intercourse and age at first pregnancy, as a basis for future interventions in the municipality of León, Nicaragua. METHODS: In a community-based cross-sectional study including 7789 households, all women aged 15-49 years (n = 10,867) were interviewed about socioeconomic, sexual, and reproductive issues. A random subsample of men (n = 388) and women (n = 413) aged 15-49 years was interviewed in more detail about sexual patterns and reproduction. RESULTS: The median age at first intercourse for women and men was 17.8 and 16.2 years, respectively. Women's average latency period to end of first pregnancy was 22 months. There was a significant tendency to start active sexual life later among today's girls aged 15-20 years, compared to the groups 21-27, 28-35, and 36-49 years old. A similar trend was found in age at first pregnancy. These secular trends were not found among men. Age at first pregnancy for current adolescents was lower among those having less formal education. CONCLUSIONS: The short latency period between first sexual intercourse and end of first pregnancy, probably reflecting lack of access to counseling and contraception, is worrying in light of the growing sexually transmitted disease/human immunodeficiency virus threat. The secular trend of later start of reproduction, however, is a positive sign which partly may be an effect of increasing education in the Nicaraguan society.

Adolescent↗
PubMed1994

Contraceptive risk-taking in a medically-underserved, low-income population.

This study examines the phenomenon of contraceptive risk-taking, which is the non-use of contraception by women who are sexually active, fertile and not pregnant or trying to become pregnant. Based on a survey sample of low-income women in their childbearing years who had not received family planning care or advice from a doctor or clinic for at least three years, the study analyzed demographic predictors of contraceptive risk-taking, and also compared levels of contraceptive knowledge and pregnancy histories of non-contraceptors versus barrier method contraceptors. Contraceptive risk-taking was found to be higher for minority women, for parous women, for those age 30 and younger and for those whose knowledge of the fertility cycle is incorrect, but was found to be only weakly related to the women's marital status. Non-contraceptors were less knowledgeable concerning contraceptive methods and substantially more likely to have had previous unwanted pregnancies due to non-use of contraception, suggesting that current contraceptive risk-taking probably represents a relatively enduring feature of reproductive behavior for a sub-group of the medically-underserved low-income population.

Adolescent↗
PubMed1994

Spontaneous quadruplet pregnancy in a woman with a personal and family history of spontaneous twin and triplet pregnancy. A case report.

Spontaneous quadruplet pregnancies are exceptional. As compared with singleton pregnancies, quadruplets are associated with a higher incidence of preterm labor, first-trimester bleeding, toxemia, anemia, stillbirths and perinatal deaths. We report a 25-year-old, black woman with a spontaneous quadruplet pregnancy. The patient had had a previous twin pregnancy and was herself a twin. The patient's mother had a history of twin and triplet pregnancies. Following the diagnosis, the patient was hospitalized and given betamethasone weekly. At 33 weeks' gestation she had spontaneous rupture of the membranes and delivered by cesarean section. The quadruplets had good Apgar scores and were discharged 5-10 weeks later in good health.

Adult↗
PubMed2005

Adolescent girls with negative pregnancy tests.

UNLABELLED: STUDY OBJECTIVES AND DESIGN: This descriptive study assessed background characteristics and attitudes about pregnancy held by adolescent girls presenting for pregnancy tests and receiving negative results. An additional aim was to determine types of health care services that would be of perceived benefit to them to reduce their risk of subsequent pregnancy. SETTING: Two health care sites in an urban community included a hospital-based adolescent clinic and a hospital-based women's health care clinic. PARTICIPANTS: Sixty-five adolescent, low-income, single women with negative pregnancy test results in a consecutive sample were included in the study. Participants had a mean age of 16.9 (+/-1.3) years and described themselves as 64.1% African American, 26.6% Latina and 9.4% white, with 81.5% enrolled or recently graduated from high school. MAIN OUTCOME MEASURES: The following variables were included: demographic characteristics, reproductive health history, personal and perceived partner attitude about the negative pregnancy test result, perceived parental influences, and teens' suggestions for health care services to prevent unintended pregnancy. RESULTS: Health history data revealed high risk status for unintended pregnancy and sexually transmitted infections (STI); 28.5% of participants were ambivalent or disappointed with their negative result, 71.4% were pleased and the majority felt that their partners would be more disappointed with the negative result than they were. Health care services that teens felt would be most helpful were one-on-one contraceptive education and discussion sessions with their own health care provider. CONCLUSIONS: Sexually active teen women with negative pregnancy test results are at high risk of subsequent pregnancy and STIs, and present important opportunities for preventive reproductive health care during visits with health care providers.

Adolescent↗
PubMed2000

Women, drugs and HIV/AIDS: results of a multicentre European study.

BACKGROUND: In the light of rising human immunodeficiency virus (HIV) incidence rates amongst women in Western Europe, a multicentred, cross-sectional study was undertaken to explore the multitude of possible factors associated with HIV in a population of female injecting drug users (IDU). METHODS: Face-to-face interviews were conducted with 1198 female IDU recruited from a variety of settings in Paris, Madrid, Rome, London and Berlin. Their HIV status was determined from antibody testing of blood or saliva samples or from written confirmation of HIV test results from a physician. A hierarchical logistic regression model was used to identify direct and indirect associations between socioeconomic factors, marginalization and risk behaviour with HIV prevalence. RESULTS: The HIV prevalence in the sample of female IDU was 27.8% (range: 1.4% in London and 52.6% in Madrid). Factors independently associated with HIV prevalence in the regression analysis included: age >25 years (OR = 2.0-2.9), left full-time education before age 14 (OR = 2.4), no fixed address (OR = 2.2), previous imprisonment (OR = 1.4), commercial sex (OR = 1.3), having a regular HIV positive sexual partner (OR = 6.6), ever shared needles (OR = 1.5) and any sexually transmitted disease (STD) infection in the last year (OR = 1.7). CONCLUSIONS: The sexual behaviour and partners of female IDU in Western Europe are as important a component in explaining the HIV epidemic in this population as other risk factors, including high-risk drug taking behaviour. Homeless IDU women may be an important residual risk group warranting future preventive interventions and women with a history of STD should be a particular target for health education. Differences in HIV prevalence across cities are very large and may be related to differences in harm reduction policies.

Adolescent↗
PubMedDate not supplied

Bone density estimates and risk factors for osteoporosis in young women.

The bone mineral density (BMD) of the calcaneus was estimated in 185 young women from the United Arab Emirates, using SAHARA ultrasound. All participants completed a questionnaire on factors potentially associated with osteoporosis. In all, 29 (15.7%) of the women were classified as having osteopenia and none as having osteoporosis. Participants with osteopenia were more likely to have had a later onset of menarche, irregular periods, lower body mass index, and a positive family history of osteoporosis. Only late menarche and low body mass index, however, were independent predictors of osteopenia.

Adult↗
PubMed2003

Physical exercise reduces risk of breast cancer in Japanese women.

To evaluate the effects of physical exercise on breast cancer risk, a large-scale case-referent study of 2376 incident breast cancer cases and 18,977 non-cancer referents was conducted using data from the hospital-based epidemiologic research program at Aichi Cancer Center (HERPACC). To adjust appropriately for possible confounders, we examined the effects within subgroups of the study population. The multivariable-adjusted odds ratio (OR) was 0.81 (95% confidence interval (CI): 0.69-0.94) for twice a week or more regular exercise. We observed a decreased risk of breast cancer for women who regularly exercised for health twice a week or more, irrespective of menopausal status, and were able to detect greater risk reductions within particular subgroups, including women who were parous, without a family history or non-drinkers. Among premenopausal women, a particularly strong protective effect of physical exercise was observed (OR=0.57, 95%CI: 0.28-1.15) for those women whose body mass index (BMI) was high (BM > or = 25). In contrast, risk reduction was found (OR=0.71, 95%CI: 0.50-1.01) among postmenopausal women whose BMI was medium (BMI: 22-25). Stratification of history of stomach cancer screening to adjust modifying effects of healthy consciousness allows a more precise assessment of the protective effect of exercise twice a week or more, independent of stomach cancer screening history. This study provides evidence that physical exercise, especially exercise twice a week or more, reduces the risk of breast cancer among Japanese women.

Adult↗
PubMed1996

Clinical significance of cough and wheeze in the diagnosis of asthma.

OBJECTIVES: (1) To determine the prevalence of cough, wheeze, and breathlessness, both as single symptoms and in combination, in primary schoolchildren and their relation to doctor diagnosed asthma. (2) To identify in areas with different levels of dust pollution whether questionnaire reported 'cough alone' (without wheeze or breathlessness) had similar risk factors to the questionnaire reported triad of 'cough, wheeze, and breathlessness'. SUBJECTS AND METHODS: Two cross sectional community surveys of primary schoolchildren (5-11 years) were performed in 1991 and 1993. Parent completed questionnaires related to socioeconomic and respiratory factors were distributed through 15 schools in three areas of Merseyside, one of which had a relatively high level of dust pollution. Data were analysed to determine the prevalence of different respiratory symptom patterns. Univariate and multiple logistic regressions were used to investigate the associations between respiratory symptom profiles and potential risk factors. RESULTS: The proportions of completed questionnaires that were returned were similarly high in both surveys, 92% in 1991 (1872 of 2035) and 87% in 1993 (3746 of 4288). The proportions of children with different respiratory symptom patterns were similar in the two surveys: in 1991, asymptomatic children 70.1% (1109 of 1583), those with cough alone 8.9% (141 of 1583), and children with the symptom triad of cough, wheeze, and breathlessness 8.3% (132 of 1583); the figures for 1993 were 69.5% (2144 of 3083), 9.2% (284 of 3083), and 7.3% (224 of 3083) respectively. The prevalence of doctor diagnosed asthma increased from 17.4% in 1991 to 22.1% in 1993. The symptom of cough alone was associated with going to school in an area of increased air pollution. The symptom triad of cough, wheeze, and breathlessness was associated with reported allergies, familial history of atopy and preterm birth. In 1991, of children with the symptom of cough alone one in eight were diagnosed asthmatic; twice as many doctors made the diagnosis on this basis in 1993. CONCLUSION: The respiratory symptom of cough alone and cough, wheeze, and breathlessness represent clinical responses to different specific risk factors. Cough alone was associated with the environmental factors of school in the dust exposed zone and dampness in the home, whereas cough, wheeze, and breathlessness related to allergic history and preterm birth, and may be the best surrogate of asthma. Diagnosis of asthma on the basis of cough alone partly explains the increased prevalence of doctor diagnosed asthma, especially in dust polluted areas.

Analysis of Variance↗
PubMed2006

Association between infant birth weight and maternal cardiovascular risk factors in the health, aging, and body composition study.

PURPOSE: Mothers who deliver a low-birth-weight (LBW) infant may themselves be at excess risk for cardiovascular disease. We investigated whether older women who bore LBW infants had higher blood pressure, lipid, glucose, insulin, interleukin 6 (IL-6), and C-reactive protein concentrations, and pulse wave velocity compared to women with normal-weight births. METHODS: Participants were 446 women with a mean age of 80 years and 47% black. Women reported birth weight and complications for each pregnancy. Analysis was limited to first births not complicated by hypertension or preeclampsia. RESULTS: Women who had delivered a first-birth infant weighing less than 2500 g had a lower body mass index (BMI) compared with women with a normal-weight (>or=2500 g) infant (26.7 versus 28.4 kg/m2; p=0.02), but they had a larger abdominal circumference for BMI (97.9 versus 95.5 cm; p=0.05). They also were marginally more likely to be administered antihypertensive medication (p=0.06). After adjustment for BMI, race, and age, women with a history of a small infant had elevations in systolic blood pressure (p=0.05) and greater IL-6 levels (p=0.02) and were more insulin resistant (p=0.05) compared with women with a normal-weight infant. CONCLUSIONS: These findings suggest that a history of LBW delivery identifies women with elevated cardiovascular risk factors.

Black or African American↗
PubMed2004

Correlates of obesity in postmenopausal women with breast cancer: comparison of genetic, demographic, disease-related, life history and dietary factors.

BACKGROUND: Obesity in women has been associated with a variety of factors, including genetic predisposition, social class, early age at menarche, exercise, alcohol consumption and diet. Obesity is a risk factor for the occurrence and the recurrence of breast cancer in postmenopausal women, perhaps because of increased exposure to estrogen, insulin and insulin-like growth factors (IGFs). The progesterone receptor (PR) and the steroid hormone receptor coactivator pCIP/ACTR/AIB1/TRAM1/RAC3 (AIB1) are hypothesized to mediate signaling crosstalk between these hormonal pathways. Polymorphisms in both genes have been described and their association with breast cancer risk reported. If genetic factors contribute to obesity, and the PR and AIB1 genes influence estrogenic, insulin and IGF pathways, then genetic patterns resulting from PR and AIB1 polymorphisms may be associated with obesity in postmenopausal women. OBJECTIVE: We compared the PR and AIB1 genotypes of postmenopausal women with breast cancer with demographic, disease-related, reproductive, lifestyle and dietary variables in terms of the strength of their relationship with obesity (BMI> or =30 kg/m2). SUBJECTS: A total of 301 postmenopausal women previously diagnosed with Stage I, II or IIIA breast cancer, who are enrolled in the Women's Healthy Eating and Living (WHEL) study (age: 34.5-70.8 y, BMI: 17.8-54.6 kg/m2). MEASUREMENTS: The PR polymorphism PROGINS was identified by PCR. The length of the AIB1 polyglutamine repeat was determined by PCR and nondenaturing gel electrophoresis or DNA sequencing. BMI was obtained at the baseline clinic visit upon entry into the WHEL study. Information about date of diagnosis, stage of disease, tumor hormone receptor status and adjuvant treatment received were obtained from medical records. Reproductive, menstrual history, demographic, family history of cancer, smoking history and exercise frequency and intensity information were obtained from questionnaires. Dietary and alcohol intake data came from four 24-h telephone recalls of food intake obtained at the study entry. RESULTS: The combined inheritance of PROGINS A1/A1 and AIB1 28/29, 28/30, 28/31, 29/29 or 29/30 (AIB1 LG) genotypes (adjusted odds ratio (OR)=2.22 (95% confidence interval 1.25-3.93)) and early age at menarche (<12 y) (adjusted OR=2.34 (1.12-4.86)) were each associated with the risk for obesity. Current use of tamoxifen (adjusted OR=0.49 (0.28-0.87)) and an alcohol intake > or =10 g/day (adjusted OR=0.28 (0.11-0.77)) were inversely associated with BMI > or =30 kg/m2. CONCLUSION: Early age at menarche and a PROGINS A1/A1+AIB1 LG genetic pattern had comparable levels of association with obesity in this cross-sectional sample of postmenopausal women with breast cancer. Since this was a cross-sectional rather than a case-control design, the association between PROGINS and AIB1 genotype and obesity found in this sample should be considered preliminary, and must be re-evaluated with a new and larger sample.

Adult↗
PubMed1999

Lemur traits and Madagascar ecology: coping with an island environment.

The last decade's lemur research includes successes in discovering new living and extinct species and learning about the distribution, biogeography, physiology, behavior, and ecology of previously little-studied species. In addition, in both the dry forest and rain forest, long-term studies of lemur demography, life history, and reproduction, have been completed in conjunction with data on tree productivity, phenology, and climate. Lemurs contrast with anthropoids in several behavioral features, including female dominance, targeted female-female aggression, lack of sexual dimorphism regardless of mating system, sperm competition coupled with male-male aggression, high infant mortality, cathemerality, and strict seasonal breeding. Hypotheses to explain these traits include the "energy conservation hypothesis" (ECH) suggesting that harsh and unpredictable climate factors on the island of Madagascar have affected the evolution of female dominance, and the "evolutionary disequilibrium hypotheses" (EVDH) suggesting that the recent megafauna extinctions have influenced lemurs to become diurnal. These hypotheses are compared and contrasted in light of recent empirical data on climate, subfossils, and lemur behavior. New data on life histories of the rain forest lemurs at Ranomafana National Park give further support to the ECH. Birth seasons are synchronized within each species, but there is a 6-month distribution of births among species. Gestation and lactation lengths vary among sympatric lemurs, but all lemur species in the rain forest wean in synchrony at the season most likely to have abundant resources. Across-species weaning synchrony seen in Ranomafana corroborates data from the dry forest that late lactation and weaning is the life history event that is the primary focus of the annual schedule. Lemur adaptations may assure maximum offspring survival in this environment with an unpredictable food supply and heavy predation. In conclusion, a more comprehensive energy frugality hypothesis (EFH) is proposed, which postulates that the majority of lemur traits are either adaptations to conserve energy (e.g., low basal metabolic rate (BMR), torpor, sperm competition, small group size, seasonal breeding) or to maximize use of scarce resources (e.g., cathemerality, territoriality, female dominance, fibrous diet, weaning synchrony). Among primates, the isolated adaptive radiation of lemurs on Madagascar may have been uniquely characterized by selection toward efficiency to cope with the harsh and unpredictable island environment.

Adaptation, Physiological↗
PubMed1993

Risk factors for hip fracture. MEDOS study: results of the Toulouse Centre.

The development of preventive strategies for hip fractures requires better identification of risk factors. The MEDOS study was designed to study prospectively the incidence of hip fracture in 14 centres from six countries and characterise risk factors. At one centre (Toulouse), data were gathered from questionnaires completed by 386 cases of hip fracture aged over 50 years and 848 age- and sex-matched controls over a 12-month period. Of the 935 variables of the MEDOS questionnaire, 235, grouped into 56 items, were statistically analysed. Odds ratios (and 95% confidence intervals) were estimated for each variable from a multiple stepwise logistic regression model. The population comprised 19.2% men and 80.8% women, with a mean age of 80 +/- 8.8 years; 80% were living in an urban area and 76% with their family. Of the 17 significant variables, moderate excess weight and a high nutritional intake of calcium were associated with a decreased risk of hip fracture. Loss of autonomy, a higher height than normal (> 1SD), and a history of previous fractures significantly increased the risk of fracture. Interestingly, all these variables accounted for only 18% of the risk of hip fracture.

Aged↗
PubMed1995

Interaction of maternal photoperiod history and food type on growth and reproductive development of laboratory meadow voles (Microtus pennsylvanicus).

The interaction of maternal photoperiod history and four diets were tested by measuring body growth, reproductive development, and pelage development in 9-week-old juvenile meadow voles. Meadow vole dams were housed in long daylengths (LD; 14 h light/day), short daylengths for 2 weeks (SD; 10 h light/day), or short daylengths for 26 weeks (PR; photorefractory) prior to mating. Immediately following parturition, one of four diets was available to dams and pups; (a) a control diet containing no 6-methoxy-2-benzoxazolinone (6-MBOA); (b) the control diet plus sprouted wheat (which contains 6-MBOA); (c) the control diet plus alfalfa harvested in spring (no 6-MBOA); and (d) the control diet plus alfalfa harvested in autumn (no 6-MBOA). By 9 weeks of age, juvenile meadow voles born to photorefractory dams and fed either spring or fall alfalfa or sprouted wheat were significantly larger and more had achieved puberty than juveniles fed only the control diet. Juveniles born to LD dams demonstrated a smaller increase in developmental rate than photorefractory juveniles when fed alfalfa and spring wheat, and juveniles of SD dams showed the smallest effect of alfalfa and sprouted wheat on development. Supplements of spring wheat and both forms of alfalfa had similar positive effects on growth and reproduction. The authors suggest that juvenile meadow voles rely on the interaction of maternal photoperiod history and the availability of nutrient-rich food such as sprouted wheat and alfalfa to time the onset of growth and puberty.

Animals↗
PubMed2005

Famine, social disruption, and involuntary fetal loss: evidence from Chinese survey data.

Relying on half a million pregnancy histories collected from Chinese women in the late 1980s, we studied nearly a quarter century of self-reported miscarriages and stillbirths in China. Our results suggest that these two forms of involuntary fetal loss are affected not only by biological and demographic factors, such as the mother's age, pregnancy order, and pregnancy history, but also by the mother's social characteristics and the larger social environment. In this article, we focus on how two social and economic crises--the Great Leap Forward famine and the Cultural Revolution--resulted in elevated risks of miscarriage and stillbirth in the Chinese population.

Abortion, Spontaneous↗
PubMed1989

Labor force participation of married women in contemporary Korea.

"This paper presents some results from the 1986 Family Life Survey of Korea. This survey was the first that was conducted in Korea with the specific purpose of understanding women's life cycle beyond marriage and fertility....A probability sample of 3,400 households representing the whole country were selected, [including] interviews of ever-married women of ages 15 to 64.... The survey collected information on household composition, with basic characteristics of members of household including health status....marriage history, including how husbands were selected, pregnancy history including the age of children when they first left home and reason for leaving home, contraceptive use, health, and women's employment at different stages of life." (SUMMARY IN KOR)

Age Factors↗
PubMed1997

Risk factors for breast carcinoma in Singaporean Chinese women: the role of central obesity.

BACKGROUND: The incidence of breast carcinoma in Singapore has nearly doubled over the past 25 years. This prospective case-control study involving 1086 women (204 cases and 882 controls) was conducted to determine significant factors associated with the risk of breast carcinoma among Chinese women in Singapore ages 45 to 69 years. METHODS: A forward stepwise logistic regression model adjusted for confounding variables of age, age at menarche, menopausal status, parity, age at first and last delivery, use of oral contraceptives, hormone replacement therapy, family history of breast carcinoma, history of benign breast biopsy, smoking history, height, weight, body mass index, and waist to hip ratio was used. RESULTS: Central obesity as indicated by women with a larger waist to hip ratio was associated with highest risk for breast carcinoma (odds ratio [OR]: 9.18; 95% confidence interval [CI],4.8-17.5 comparing last and first quintile; P < 0.0001, chi-square test for trend). Significant trends were also noted for increasing height and breast carcinoma risk (P = 0.003, chi-square test). Women who were taller than 159 cm (OR: 2.3; 95% CI, 1.4-3.9) had approximately twice the risk of women shorter than 150 cm. Body mass index as a measure of generalized obesity did not significantly predict risk for breast carcinoma. Reproductive and menstrual factors significantly related to risk for breast carcinoma were number of deliveries (OR: 0.81; 95% CI, 0.7-0.9; P < 0.001), age at last delivery (P = 0.03), and use of hormone replacement therapy (OR: 0.54; 95% CI, 0.3-0.9; P = 0.01). Previous breast biopsy for benign disease was also associated with a higher risk for breast carcinoma (OR: 3.5; 95% CI, 2.1-5.7; P < 0.001). CONCLUSIONS: The authors conclude that the risk of breast carcinoma is strongly associated with changes in lifestyle related to caloric intake (central obesity and height) and reproductive or menstrual factors (number of deliveries, age at last delivery, age at menopause, and breast feeding). Better and excess nutrition in early and later years of life and fewer births (related to rapid urbanization) may explain in part the increasing incidence of breast carcinoma occurring in Singapore.

Aged↗