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PubMed1995

Oral contraceptive use and risk of breast cancer in older women (New Zealand).

The effect of oral contraceptive (OC) use at older ages on the risk of breast cancer was examined in a national population-based case-control study conducted in New Zealand. A total of 891 women aged 25 to 54 years with a first diagnosis of breast cancer, and 1,864 control subjects, randomly selected from the electoral rolls, were interviewed. The relative risk (RR) of breast cancer for women aged 45 to 54 years at diagnosis who had ever used OCs was 1.0 (95 percent confidence interval [CI] = 0.77-1.3). There was no significant increase in risk of breast cancer among recent users of OCs of any age. Analyses according to age at first and last use among women aged 40 years and older at diagnosis showed no group with an elevated risk of breast cancer. Women who had used OCs for 10 years or longer after age 40 had an apparent increase in risk (RR = 2.7, CI = 0.97-7.5), but the trend in risk with duration of use was not significant. These findings suggest that OC use in older women does not affect their risk of breast cancer appreciably, but it is not possible to rule out a modest increase in risk with such use.

Adult↗
PubMed1995

Olive oil, other dietary fats, and the risk of breast cancer (Italy).

Data from a multicenter case-control study on breast cancer conducted in Italy have been used to analyze the relationship of olive oil and other dietary fats to breast cancer risk. Cases were 2,564 women hospitalized with histologically confirmed, incident breast cancer. Controls were 2,588 women admitted to the same network of hospitals for acute, non-neoplastic, non-hormone related, non-digestive tract disorders. Cases and controls were interviewed between 1991 and 1994 using a validated food-frequency questionnaire. The data were modelled through multiple logistic regression controlling for demographic and reproductive breast-cancer risk factors, energy intake and, mutually, for types of dietary fat. For olive oil, compared with the lowest quintile, the odds ratios (OR) were 1.05, 0.99, 0.93, and 0.87 for increasing quintiles of intake; in a model postulating linear logit increase, the OR per unit (30 g) was 0.89 (95 percent confidence interval [CI] = 0.81-0.99, P = 0.03). Among other oils or fats considered, the OR for the highest level of intake was 0.72 (CI = 0.6-0.9) for a group of specific seed oils (including safflower, maize, peanut, and soya) compared with nonusers. The ORs for the highest cf lowest level of intake were 0.80 for mixed or unspecified seed oils, 0.95 for butter, and 0.96 for margarine. The study, based on a large dataset from various Italian regions, shows an inverse relationship of breast cancer risk with intake of olive oil and other vegetable oils, but not with butter or margarine.

Adult↗
PubMed1997

Influence of hormonal and reproductive factors on the risk of vertebral deformity in European women. European Vertebral Osteoporosis Study Group.

The aim of this study was to determine whether variation in the level of selected hormonal and reproductive variables might explain variation in the occurrence of vertebral deformity across Europe. A population-based cross-sectional survey method was used. A total of 7530 women aged 50-79 years and over were recruited from 30 European centres. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs which were taken according to a standard protocol. After adjusting for age, centre, body mass index and smoking, those in the highest quintile of menarche (age > or = 16 years) had an increased risk of vertebral deformity (odds ratio [OR] = 1.48; 95% confidence interval [CI] 1.16, 1.88). Increased menopausal age (> 52.5 years) was associated with a reduced risk of deformity (OR = 0.78; 95% CI 0.60, 1.00), while use of the oral contraceptive pill was also protective (OR = 0.76; 95% CI 0.58, 0.99). There was a smaller protective effect associated with one or more years use of hormone replacement therapy, though the confidence limits clearly embraced unity. There was no apparent effect of parity or breast-feeding on the risk of deformity. We conclude that oestrogen status is an important determinant of vertebral deformity. Ever use of the oral contraceptive pill was associated with a 25% reduction in risk of deformity though the effect may be a result of the higher-dosage oestrogen pills used in the past. Parity and breast-feeding do not appear to be important and would appear to have little potential for identification of women at high risk of vertebral deformity.

Age Factors↗
PubMed1994

Ectopic pregnancies after in vitro fertilization and embryo transfer.

OBJECTIVE: Our objective was to analyze the risk factors, stimulation characteristics, and future fecundity of patients with ectopic pregnancies after in vitro fertilization (IVF). METHODS: We retrospectively evaluated all cases of ectopic pregnancy occurring between January 1989 and March 1993 (Cornell series 1 to 17). A case-control group of intrauterine pregnancies was used for comparison of the stimulation and transfer characteristics. RESULTS: Twenty-seven of 1123 pregnancies (2.4%) were ectopic, following 2812 fresh IVF embryo transfers, while 8 of 105 pregnancies (7.6%) were ectopic, following 405 frozen-thawed embryo transfers. Tubal factor was the cause of infertility in the majority (85.7%) of ectopic pregnancies. No difference was found between the ectopics and the matched controls in stimulation and transfer characteristics. Thirty ectopic pregnancies were ampullary, two were interstitial, two were cervical, and one was heterotopic. Twenty of the patients subsequently underwent 29 IVF attempts, with a pregnancy rate of 41.4% per transfer. CONCLUSIONS: Ectopic pregnancy after IVF appears to be related to preexisting tubal pathology; embryo transfer of cryopreserved thawed embryos in a natural cycle may result in a higher ectopic rate in these patients; in subsequent IVF cycles the intrauterine pregnancy rate of these patients is not decreased.

Adult↗
PubMed1986

Determinants of family size in rural Galicia (Spain).

"The determinants of complete family size and offspring survival were assessed by means of family reconstitution data from 19th and 20th century rural [populations] of Northwest Spain. The reproductive performances of families were submitted to a stepwise regression analysis in which the number of children born alive and those surviving to reproductive age per family were taken as dependent variables, while 13 other variables were defined as independent. Infant mortality appears to explain most fertility variation; an earlier marital age and at first maternity leads to an increased family size. Survival seems to be the result of the apposite interaction of both fertility and mortality in early childhood."

Age Factors↗
PubMed2003

Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS).

The aim of this analysis was to determine the influence of lifestyle, anthropometric and reproductive factors on the subsequent risk of incident vertebral fracture in men and women aged 50-79 years. Subjects were recruited from population registers from 28 centers across Europe. At baseline, they completed an interviewer-administered questionnaire and had lateral thoraco-lumbar spine radiographs performed. Repeat spinal radiographs were performed a mean of 3.8 years later. Incident vertebral fractures were defined morphometrically and also qualitatively by an experienced radiologist. Poisson regression was used to determine the influence of the baseline risk factor variables on the occurrence of incident vertebral fracture. A total of 3173 men (mean age 63.1 years) and 3402 women (mean age 62.2 years) contributed data to the analysis. In total there were 193 incident morphometric and 224 qualitative fractures. In women, an age at menarche 16 years or older was associated with an increased risk of vertebral fracture (RR = 1.80; 95%CI 1.24, 2.63), whilst use of hormonal replacement was protective (RR = 0.58; 95%CI 0.34, 0.99). None of the lifestyle factors studied including smoking, alcohol intake, physical activity or milk consumption showed any consistent associations with incident vertebral fracture. In men and women, increasing body weight and body mass index were associated with a reduced risk of vertebral fracture though, apart from body mass index in men, the confidence intervals embraced unity. For most variables the strengths of the associations observed were similar using the qualitative and morphometric approaches to fracture definition. In conclusion our data suggest that modification of other lifestyle risk factors is unlikely to have a major impact on the population occurrence of vertebral fractures. The important biological mechanisms underlying vertebral fracture risk need to be explored using new investigational strategies.

Age Distribution↗
PubMed2003

Influence of reproductive factors on hip fracture risk in Chinese women.

To assess the relationships between reproductive factors and the risk of hip fractures in postmenopausal Chinese women, the authors analyzed data from a matched case-control study conducted in the Beijing metropolitan area among women aged 50 years and older. One hundred and fifty-six cases who sustained a hip fracture after minor trauma between January 1994 and May 1996 were identified from hospital records, of whom 121 could be located (78%). All cases agreed to be interviewed. Two controls were selected from the neighbors of each hip fracture case and matched to the cases by age within a 5-year range. Information on reproductive factors and potential confounders was obtained through personal interviews. Multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using conditional logistic regression. Multiple imputation procedure was also employed to account for item non-response. Although univariate analyses revealed that later age at menopause, parity and breastfeeding were protective factors, only breastfeeding was statistically associated with risk of hip fracture after adjusting for potential confounding in multivariable logistic models. As compared with women with average duration of breastfeeding per child < or =6 months, women with average duration of breastfeeding per child 7-12 months, 13-23 months, and > or =24 months had odds ratios of 1.14 (95% CI: 0.48, 2.72), 0.28 (95% CI: 0.10, 0.82) and 0.34 (95% CI: 0.13, 0.92), respectively. Among parous women, 13% reduced risk was associated with every 6 months increase in breastfeeding per child. The authors conclude that extended breastfeeding is associated with a reduced hip fracture risk among Chinese women in Beijing.

Aged↗
PubMed2006

Exposure to traffic pollutants and effects on 17-beta-estradiol (E2) in female workers.

OBJECTIVE: The aim of the study is to evaluate whether the occupational exposure to urban pollutants including endocrine disruptors (EDs) could cause alterations in plasma 17-beta-estradiol (E2) levels and related diseases (adverse pregnancy outcome and mental health disorders) in female traffic police compared to a control group. METHODS: After excluding the subjects with the principal confounding factors, traffic police and controls were matched by age, years of police work, age of menarche, menstrual cycle day, body mass index (BMI), drinking habit, cigarette smoking habit, habitual intake of soy or liquorice in diet and habitual consumption of Italian coffee. Thirty-seven traffic police and 31 controls (seventh day; follicular phase of the ovarian cycle); 38 traffic police and 42 controls (14th day; ovulatory phase of the ovarian cycle); and 25 traffic police and 28 controls (21st day; lutheal phase of the ovarian cycle) were included in the study and then matched for the above-mentioned variables. RESULTS: In follicular and in lutheal phases, mean E2 levels were significantly lower in traffic police compared to controls. The distribution of E2 values in traffic police and controls was significant in follicular, ovulatory and lutheal phases. In ovulatory phase, mean E2 levels were lower but not significant in traffic police compared to controls. An increase was found concerning mental health disorders referred to in the questionnaire items in traffic police compared to controls, although the difference was not significant. CONCLUSIONS: Considering that the potential confounding effect of extraneous factors was controlled for by restricting the study population and by matching traffic police and controls on the above-mentioned variables, our results suggest that occupational exposure to urban pollutants, EDs included, might alter E2 plasma concentrations. E2 could be used in occupational set as an early biomarker of exposure to urban pollutants, valuable for the group, even before the onset of the related pathologies (adverse pregnancy outcome and mental health disorders).

Adult↗
PubMed1997

Neonatal morbidity and mortality associated with maternal haemolysis elevated liver enzymes and low platelets syndrome.

UNLABELLED: To compare the impact of maternal haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, uncomplicated hypertension in pregnancy (HIP), and no hypertension (controls) on neonatal morbidity and mortality, 108 infants were matched with respect to gestational age, date of birth, and gender. The HELLP group infants had more grade 3 and 4 respiratory distress syndromes (36%) than the HIP group (19%) or controls (11%). Cardiovascular instability (arterial hypotension, volume resuscitation) was significantly more common in HELLP neonates (20% and 31%) than in HIP infants (9% and 6%) or controls (3% and 9%). Both, HELLP and HIP infants showed a higher incidence of growth retardation than the controls. After 32 weeks of gestation the incidence of severe neonatal morbidity was not different. CONCLUSION: : Before 32 weeks of gestation both respiratory and cardiovascular morbidity and intra-uterine growth retardation associated with HIP is further aggravated by a maternal HELLP syndrome.

Adult↗
PubMed2000

Deaths from cerebrovascular diseases correlated to month of birth: elevated risk of death from subarachnoid hemorrhage among summer-born.

It has been suggested that maternal nutrition, and fetal and infant growth have an important effect on the risk of cardiovascular disease in adult life. We investigated the population-based distribution of deaths from cerebrovascular diseases (ICD9 codes 430, 431, or 434) in Japan in 1986-1994 as a function of birth month, by examining death-certificate records. For a total of 853 981 people born in the years 1900-1959, the distribution of the number of deaths according to the month of birth was compared with the distribution expected from the monthly numbers of all births for each sex and for the corresponding birth decade. For those born between 1920 and 1949, there were significant discrepancies between the actual numbers of deaths from subarachnoid hemorrhage (ICD9 430) and the numbers expected, and these differences were related to the month of birth. Those born in summer, June-September, consistently had an elevated risk of death, particularly men, where the excess risk was 8%-23%. This tendency was also observed, less distinctly but significantly, for deaths from intracerebral hemorrhage (ICD9 431), but was not observed for those dying from occlusion of the cerebral arteries (ICD9 434). The observation that the risk of dying from subarachnoid hemorrhage was more than 10% higher among those born in the summer implies that at least one in ten deaths from subarachnoid hemorrhage has its origin at a perinatal stage. Although variations in hypertension in later life, which could possibly be "programmed" during the intra-uterine stages, could be an explanation for this observation, the disease-specific nature of the observation suggests the involvement of aneurysm formation, which is a predominant cause of subarachnoid hemorrhage.

Aged↗
PubMed2006

Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium.

129 mothers referred to specialist psychiatric services in Birmingham and Christchurch were interviewed with the Birmingham Interview. Anxiety disorders were more frequent than depression during pregnancy, and equally frequent after delivery. The focus of pre- and post-partum anxiety may be important for psychological treatment. At a severe level, the most common prepartum theme was fear of foetal death; this was associated with a history of reproductive losses or infertility. After delivery the commonest themes were the pathological fear of cot death and fear of the criticism of mothering skills (which was a clue to a disordered mother-infant relationship). Clinicians should be vigilant for obsessional disorders, querulant (complaining) disorders, post-traumatic stress disorder, conjugal jealousy and dysmorphophobic states, which are all quite common. Patients with "postpartum depression" usually had at least one other (co-morbid) disorder, and 27% had two or more. These findings emphasize the diversity of postpartum psychiatric illness.

Adolescent↗