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PubMedDate not supplied

Do "helpers at the nest" increase their parents' reproductive success?

"Helpers at the nest," usually offspring of a preceding litter who contribute by feeding the young to increase the reproductive success of a breeding pair, are known in many species of birds and mammals. Although similar behaviors were described by ethnological observations in several human societies, there is a lack of data on their existence and role. This study of 794 reproductive life histories of post-menopausal Berber women of Southern Morocco aims to provide such information. Results show that the presence of "probable helpers" in the household is related to higher fertility scores and is associated with improved survival of offspring to sexual maturity. In contrast to sparse observations from other human societies, there is no indication that child caretaking would be specific to eldest daughters. Although the association between offspring survival and helping patterns seems highly probable, there is no confirmation that child caretaking per se is the relevant variable. Contrary to nonhuman helpers at the nest, workloads of children range from housekeeping to light agricultural tasks, and are not focused on assisting younger siblings. The improvement of reproductive success is probably the result of multiple interactions, among which the network of kinship would play a role at both the levels of economy and reciprocal assistance.

Adolescent↗
PubMed1996

Risk factors for cryptorchidism: a nested case-control study.

A nested case-control study of cryptorchidism (i.e. undescended testicles) was undertaken as part of a hospital-based cohort study of 6699 singleton male neonates in New York City. Since some of the cryptorchid infants experienced spontaneous descent of their testes, separate analysis was performed for this third group of 'late descenders' (n=140). Cases (n=63) represented infants whose testes remained undescended at the one year assessment. Controls (n=219) represented the next male infant who was delivered immediately after an infant who was cryptorchid at birth. The only independent risk factors for cryptorchidism were Asian ethnic group (adjusted odds ratio (OR) = 3.90, 95% confidence interval (CI) = 1.22-12.41), swollen legs or feet during pregnancy (adjusted OR = 2.16, 95% CI = 1.15-4.04), a family history of cryptorchidism (adjusted OR = 4.32, 95% CI = 1.91-9.80), low birthweight (adjusted OR = 4.10, 95% CI = 1.39-12.08), and use of analgesics during pregnancy (adjusted OR = 1.93, 95% CI = 1.03-3.62). Multiple logistic regression analysis was also performed to identify those factors that were associated with late testicular descent. In this analysis the independent risk factors were black or Hispanic ethnicity (adjusted OR = 2.05, 95% CI = 1.09-3.83), a family history of cryptorchidism (adjusted OR = 4.25, 95% CI = 1.84-9.78), consumption of cola-containing drinks during the pregnancy (adjusted OR = 2.09, 95% CI = 1.10-3.99), a low birthweight delivery (adjusted OR = 9.78, 95% CI = 3.39-28.20), and preterm birth (adjusted OR = 4.01, 95% CI = 1.66-9.70).

Birth Weight↗
PubMed1987

A prospective study of age at menarche, parity, age at first birth, and coronary heart disease in women.

Reproductive events in women are associated with alterations in blood lipids and blood pressure and may therefore influence determinants of coronary heart disease. To investigate the risk of coronary heart disease in relation to age at menarche, parity, and age at first birth, the authors evaluated prospectively the experience of 119,963 US women aged 30-55 years who were free from coronary heart disease in 1976 and were followed through 1982. During 700,809 person-years of observation, 308 incident cases of nonfatal myocardial infarction or fatal coronary heart disease occurred. Younger age at menarche was weakly associated with coronary heart disease (age-adjusted rate ratio of 1.3 for menarche before age 11 years compared with menarche at age 13 years; chi, Mantel extension test for trend = -1.1, p = 0.2). Nulliparous women experienced only a slightly higher rate of coronary heart disease than parous women (rate ratio = 1.2, 95 per cent confidence interval 0.8-1.8). Among parous women, there was no alteration in risk with increasing number of births. Likewise, there was no significant association between age at first birth and coronary heart disease (chi, Mantel extension test for trend = -0.4, p = 0.4). Established risk factors for coronary heart disease nevertheless showed expected relations. These findings show no important association between reproductive experiences and risk of coronary heart disease.

Adult↗
PubMedDate not supplied

Gestational diabetes in a Mexican-U.S. border population: prevalence and epidemiology.

OBJECTIVE: To determine the prevalence of gestational diabetes (GD) in a Mexican-U.S. border population and to observe the response of such a population to a 100 gram challenge of glucose. RESEARCH DESIGN AND METHODS: The sample was a cross section of 519 pregnant women accesing different health institutions in Juarez, Mexico, with 24-36 weeks of gestation. An oral glucose tolerance test (OGTT) with a 100 gram challenge of glucose was done on all. Results were interpreted according to the diagnostic criteria of O'Sullivan and Mahan. Information on family history of diabetes, obstetric history, height and weight was obtained. RESULTS: A total of 20.4% of the patients examined had some kind of glucose intolerance 11% with GD and 9.4% with one abnormal value during the glucose tolerance test. The patients with GD tended to be older, had higher gravidity, lower height, higher weight and reported frequently a family history of diabetes. The patients with one abnormal value were similar to those with GD in weight and number of pregnancies, and were comparable to the group with normal glucose tolerance test in height and family history of diabetes. CONCLUSIONS: We found a high prevalence of GD and of one abnormal value during the OGTT in a Mexican population. The recommendations for screening for GD must be consistently implemented in pregnant women of Mexican ancestry.

Adult↗
PubMed1992

Regulatory effect of antiphospholipid antibodies on signal transduction: a possible model for autoantibody-induced reproductive failure.

OBJECTIVES: The broad range of reproductive processes apparently affected by antiphospholipid antibodies suggests that antiphospholipid antibodies have to exert their clinical effects at every basic cellular level. Because phospholipids constitute essential components of every cell membrane, and because signal transduction processes are dependent on second messengers with phospholipid epitopes, we investigated the hypothesis that interference with signal transduction processes by antiphospholipid antibodies could represent such a basic cellular process. STUDY DESIGN: To test this hypothesis we established an in vitro placental culture system in which the stimulation of explants by phospholipase A2 and phospholipase C in the presence of normal human serum resulted in a significant increase in human chorionic gonadotropin secretion. RESULTS: When normal human sera were replaced with antiphospholipid antibody-containing sera from two women with established histories of reproductive failure, this increase in human chorionic gonadotropin production was inhibited 42% to 44% under phospholipase A2 stimulation and by 34% to 39% under phospholipase C stimulation. The hypothesis that antiphospholipid antibodies can interfere with signal transduction processes was further strengthened by the observation that antiphospholipid antibody-positive sera contained significantly higher immunoglobulin A antibody reactivity toward the second messenger inositol 1,4,5-triphosphate than control sera (p less than 0.049). CONCLUSIONS: These observations suggest the possibility that if present at excessive levels antiphospholipid antibodies may exert their adverse effect on reproductive processes through the interception of signal transduction processes.

Antibodies↗
PubMedDate not supplied

Maternal age and birth outcomes: data from New Jersey.

The effects of maternal age on low birth weight, newborns' hospital costs and infant mortality were estimated based on individual 1989 and 1990 vital statistics records from New Jersey that were linked with uniform billing hospital discharge records. Results of multivariate analyses show a U-shaped relationship between maternal age and low birth weight among whites, with the youngest (younger than 15) and oldest (aged 40 and older) mothers being at higher risk than 25-29-year-olds; older teenagers were not at any significantly increased risk. Among blacks, however, 15-19-year-olds faced significantly lower risks of delivering low-birth-weight babies than did black women aged 25-29. Both black and white mothers in their 30s were significantly more likely to deliver a low-birth-weight baby than women aged 25-29 of the same race. The multivariate analysis also showed that newborn hospitalization costs increased with maternal age among both blacks and whites. The seemingly poorer birth outcomes of teenage mothers appear to result largely from their adverse socioeconomic circumstances, not from young maternal age per se.

Adolescent↗
PubMed1996

Risk factors of anemia among women in the child bearing period and preschool children in Alexandria.

This study was carried out to determine the risk of some social and biological maternal factors which may contribute to occurrence of anemia among mothers and preschool children. A community based comparative study was chosen for the conduction of this work. The target population were 400 women in the child bearing period, having at least one preschool child (440). Capillary blood samples were taken by finger prick method and hemoglobin level was estimated by Sahly method. According to the cut off level of hemoglobin, women were classified into anemic and non anemic. In addition to that, 440 preschool children belonging to these women were classified according to the cut off level of their hemoglobin into 165 anemic children and 275 non anemic ones. An interview questionnaire was used to collect the data. Analysis of results showed that age of mother (30 years and above), illiteracy, high parity, history of previous abortion, history of previous perinatal mortality, small inter-birth interval and non use of contraceptives are significant risk factors for mothers. However, mother occupation and state of pregnancy has no role in occurrence of anemia among mothers. In addition to that, high parity, history of previous abortion, history of perinatal mortality, short inter-birth interval, non use of contraceptives and pregnancy are maternal risk factors responsible for anemia among preschool children. While, mother age, education and occupation has no role for occurrence of anemia among preschool children.

Adolescent↗
PubMedDate not supplied

Ovarian cancer: epidemiology, biology, and prognostic factors.

Ovarian cancer varies widely in frequency among different geographic regions and ethnic groups, with a high incidence in Northern Europe and the United States, and a low incidence in Japan. The majority of cases are sporadic, and only 5% to 10% of ovarian cancers are familial. The etiology of ovarian cancer is poorly understood. Models of ovarian carcinogenesis include the theory of incessant ovulation, in which a person's age at ovulation, i.e., lifetime number of ovulatory cycles, is an index of her ovarian cancer risk. Excessive gonadotropin and androgen stimulation of the ovary have been postulated as contributing factors. Exposure of the ovaries to pelvic contaminants and carcinogens may play a role in the pathogenesis of ovarian cancer. Epidemiologic and molecular-genetic studies identify numerous risk and protective factors. The most significant risk factor is a family history of the disease. Recent advances in molecular genetics have found mutations in the BRCA1 and BRCA2 tumor suppressor genes responsible for the majority of hereditary ovarian cancer. Additional risk factors include nulliparity and refractory infertility. Protective factors include multiparity, oral contraceptives, and tubal ligation or hysterectomy. With five years of oral contraceptive use, women can cut their risk of ovarian cancer approximately in half; this also holds true for individuals with a family history. Stage at diagnosis, maximum residual disease following cytoreductive surgery, and performance status are the three major prognostic factors. Using a multimodality approach to treatment, including aggressive cytoreductive surgery and combination chemotherapy, five-year survival rates are as follows: Stage I (93%), Stage II (70%), Stage III (37%), and Stage IV (25%).

Antineoplastic Agents↗
PubMed1994

Risk factors for spontaneous abortion: a preliminary study on Saudi women.

A preliminary case-control study was conducted on Saudi women to detect possible risk factors for spontaneous abortion (SA). Two hundred and twenty six consecutive women hospitalised for SA and 226 women admitted for normal delivery and used as controls, were studied. Women with SA were significantly older at menarche (Relative Risk (RR) = 3.2), more frequently married to blood-related husbands (RR = 2.1) and husbands older than 50 years (RR = 2.4). Number of previous abortions related linearly to the risk of aborting spontaneously in the next pregnancy. Compared to primigravidas, the RR was 3.2 if the outcome of the most recent pregnancy was SA, and 0.8 if it was a livebirth. A family history of SA was more common among cases (RR = 4.6). Spontaneous abortion was also associated with daily consumption of more than 150 mg of caffeine, abdominal trauma, infection and fever during pregnancy. No significant association, however, emerged with maternal age, social class, education, exposure to video display terminals, parity, use of contraception, diabetes or obesity. The application of these data in clinical practice and future research needs are discussed.

Abortion, Spontaneous↗
PubMed1994

Dysfunctional uterine bleeding in adolescents.

This retrospective, multicenter analysis was conducted on all adolescents admitted to three pediatric hospitals in Montreal, Quebec, Canada, over a 10-year period (1981-1991) with a primary diagnosis of dysfunctional uterine bleeding. The purpose was to assess the frequency of underlying medical disorders and their response to medical therapy. Sixty-one patient charts were identified. Newly diagnosed hematologic abnormalities were found in two patients (one with immune thrombocytopenic purpura and one with acute promyelocytic leukemia). Furthermore, all patients who were evaluated had normal factor VIII levels, partial thromboplastin times and prothrombin times. Twenty-nine percent of the patients had a past history of a significant medical problem. The mean age at presentation was 13.8 +/- 2.1 (SD) years. More than 50% of the patients had a history of irregular bleeding. Most patients (93.4%) responded to medical management. Only five (8.2%) required dilation and curettage. The history of irregular cycles, the early presentation after menarche, the infrequency of hematologic problems but high frequency of significant medical problems led us to conclude that the etiology of dysfunctional uterine bleeding in adolescence is often related to persistent immaturity of the hypothalamic-pituitary-ovarian axis. Medical therapy is highly effective in controlling such bleeding. Dilation and curettage is rarely required.

Administration, Oral↗
PubMed2005

Hysteroscopic management in submucous fibroids to improve fertility.

OBJECTIVE: To evaluate prospectively the reproductive performance following hysteroscopic myomectomy in women with submucous fibroids and wishing a pregnancy. STUDY DESIGN: Twenty-nine consecutive women wishing a pregnancy with a previously diagnosed submucous fibroid as a sole cause for reproductive failure were treated by hysteroscopic myomectomy. Fourteen women suffered from primary infertility and 15 women had previous pregnancies with a poor obstetric outcome. The myomas were intracavitary (n = 25) and intramural class 1 (n = 4). None of the patients had type 2 or multiple submucousal fibroids. Myoma size was not larger than 5 cm (the mean was 13.3 mm). Before myomectomy, the outcome reproductive data were recorded prospectively. Following myomectomy, the cumulative rate of first pregnancies, live birth rate and the hysteroscopic anatomical results were assessed and compared with that before surgery. RESULTS: The mean duration of follow-up before and after myomectomy was comparable. Twenty-one women (72.4%) experienced 30 pregnancies after myomectomy. Thirteen women gave birth to 16 live infants. Compared with previous pregnancies, the rate of deliveries increased from 3.8% to 63.2% and the abortion rate decreased from 61.6% to 26.3%. No complications occurred during myomectomy. The hysteroscopic anatomical results were good in the majority of cases. CONCLUSIONS: This prospective study demonstrates that hysteroscopic myomectomy at present is the method of choice to improve the cumulative pregnancy rate as well as the live birth rate in selected women with submucous myomas and a history of reproductive failure.

Adult↗
PubMed1997

Factors associated with term low birthweight in Cardiff, Wales.

This project was undertaken to examine the associations of a number of risk factors with impaired fetal growth, exemplified by delivery of a low-birthweight infant at term (TLBW). Utilising a large database of largely homogeneous (white) births in Wales, the Cardiff Births Survey, multivariable analysis by logistic regression examined the relative importance of these risk variables. Significant independent associations with TLBW were found (in decreasing order of magnitude) for low maternal weight, pre-eclampsia, smoking, short maternal height, late pregnancy bleeding, early pregnancy bleeding, history of a previous stillbirth, primiparity and older maternal age. In this population, risk of TBLW was associated with a number of demographic, medical and social factors. Of these, only smoking is likely to be modified by intervention.

Adolescent↗
PubMed2002

Predictors of outcome of mammography in the National Health Service Breast Screening Programme.

BACKGROUND: Little is known about the factors influencing the risk of recall for assessment, invasive diagnostic procedures, and early rescreening after screening mammography. METHODS: From June 1996 to March 1998 women attending screening at 10 National Health Service Breast Screening Programme (NHSBSP) centres completed a self administered questionnaire and were followed up for their screening outcome. RESULTS: 1969 (3.3%) out of 60 443 women aged 50-64 who had never used hormone replacement therapy (HRT) were recalled for assessment but were not diagnosed with breast cancer (defined here as false positive recall). After adjustment for the variation between centres, false positive recall was decreased significantly among women who were likely to have had a previous NHSBSP mammogram (odds ratio (OR) 0.49, 95% confidence interval (95% CI) 0.38 to 0.63 for likely versus unlikely), who were postmenopausal (OR 0.65, 95% CI 0.56 to 0.76 for postmenopausal v premenopausal) and increased significantly for women reporting previous breast surgery (OR 1.64, 95% CI 1.42 to 1.89). Although false positive recall decreased significantly with parity and increasing body mass index, these effects were not large and no significant variation was found with age, education, family history of breast cancer, oral contraceptive use, sterilisation, exercise, smoking, or alcohol consumption. Altogether 655 (1.1%) women had an invasive diagnostic procedure; no personal characteristics were predictive of this outcome, 286(0.5%) were referred for early rescreening, and this was increased significantly by nulliparity and a family history of breast cancer. INTERPRETATION: Premenopausal women, those without a previous NHSBSP mammogram, and women with previous breast surgery have an increased risk of false positive recall by the NHSBSP.

Age Factors↗
PubMed2000

Characteristics of a population of women with breast implants compared with women seeking other types of plastic surgery.

Several previous studies have shown that breast implant patients demonstrate a number of differences compared with the general population. However, studies have not compared patients with breast implants with women receiving other types of plastic surgery, of interest because this latter group has been proposed as a comparison group for assessing the long-term health effects experienced by breast implant patients. Questionnaire data obtained from 7447 breast implant patients and 2203 patients with other types plastic surgery were collected during the course of a retrospective cohort study, to determine whether implant patients demonstrate different characteristics compared with a more restricted group of patients. In contrast to previous investigations that compared implant patients with the general population, distinctive differences with respect to family income, number of pregnancies, alcohol consumption, cigarette smoking, or histories of previous gynecologic operations or operations for benign breast disease were not found. However, implant patients were significantly more likely than other plastic surgery patients to be white, have low levels of education, have early ages at first birth, be thin, and be screened frequently for breast disease. Furthermore, implant patients reported somewhat greater use of exogenous hormones and familial histories of rheumatoid arthritis. These results support the notion that other plastic surgery patients are a more appropriate comparison group than women in the general population for studies of the health effects of breast implants; however, there continue to be distinctive characteristics possessed by breast implant patients, which need to be taken into account in an assessment of what disease effects can be uniquely attributed to silicone breast implants.

Adult↗
PubMed2003

Socio-demographic characteristics of women with endometrial carcinoma.

The aim of the paper was to describe general health, socio-economic and demographic characteristics of endometrial cancer patients in comparison to healthy women. During years 1996-2002, 100 women with endometrial carcinoma and 100 healthy women were interviewed about their health, socio-economic and demographic status and compared. The endometrial cancer patients were more often older, postmenopausal, with higher body weight, and frequent history of hypertension and diabetes than controls. The healthy women had greater number of deliveries, used oral contraceptive and hormone replacement therapy, were smokers and alcohol consumers and lived in urban centers more often than patients. The cancer patients had worse socio-economic status, less education, and were more frequent single and widowed than controls. These data may be relevant for public health services in the future to improvement quality of life of the cancer patients.

Croatia↗
PubMed2005

The relationship of maternal attributes, resources, and perceptions of postpartum experiences to depression.

The relationships of maternal attributes, resources, and perceptions of the postpartum experience to postpartum depression (PPD) were examined. One hundred and forty-three mothers completed measures of maternal attributes, resources, and perceptions of the postpartum experience, as well as depressed mood and clinical depression symptoms. Results from canonical correlation analysis revealed two patterns. Pattern 1: Women without history of depression, more emotional support from partners, higher parenting evaluation, lower centrality of the infant in the mother's thoughts and actions, and fewer life changes had lower depressed mood and fewer clinical depression symptoms than their counterparts. Pattern 2: Mothers without history of depression who were married, with higher financial stress, and lower parenting evaluation had higher depressed mood, but not more clinical depression symptoms. Maternal age, parity, time since delivery, income, and help from partner were unrelated to either depression indicator. These patterns suggest multiple paths to PPD, and the need for routine mental health assessment and exploration of women's perceptions of their postpartum experience.

Adolescent↗