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PubMed1983

Analysis of completed reproductive histories: a cautionary tale.

Recent authors have suggested that cross-sectional studies of adverse outcome of pregnancy are misleading, and that the only valid method of analysis controls for eventual number of pregnancies. The present study shows, by simple examples, that such a method produces results that cannot be interpreted in the way claimed for them.

Birth Order↗
PubMed1986

Reproductive history and intrapartum fever.

Washington State Birth Registry data of the years 1980-1982 of 803 women with intrapartum fever, who gave birth to a singleton, and of 1,714 control women without such diagnosis selected at random from the child-bearing population were studied for risk factors and maternal and neonatal outcome variables. Cases were significantly more often less than 21 years old, nonwhite, unmarried, nulligravid, and nulliparous than controls, and had significantly shorter gestational ages and longer birth intervals. The risk of intrapartum fever was higher in nulliparous than in nulligravid women [adjusted odds ratio (OR) 4.0 and 2.3, respectively]. This risk difference led to the discovery of increased fetal and perinatal losses prior to the pregnancy under study: cases lost 160 of 390 (41%) previous pregnancies while controls lost 142 of 1,180 (12%; OR = 5.1; p less than 0.001). In a matched analysis, spontaneous abortions (less than 20 weeks gestation) immediately preceding the pregnancy under study were found to increase the risk of intrapartum fever by 2.7 times.

Abortion, Spontaneous↗
PubMed2006

How good is probabilistic record linkage to reconstruct reproductive histories? Results from the Aberdeen Children of the 1950s study.

BACKGROUND: Probabilistic record linkage is widely used in epidemiology, but studies of its validity are rare. Our aim was to validate its use to identify births to a cohort of women, being drawn from a large cohort of people born in Scotland in the early 1950s. METHODS: The Children of the 1950s cohort includes 5868 females born in Aberdeen 1950-56 who were in primary schools in the city in 1962. In 2001 a postal questionnaire was sent to the cohort members resident in the UK requesting information on offspring. Probabilistic record linkage (based on surname, maiden name, initials, date of birth and postcode) was used to link the females in the cohort to birth records held by the Scottish Maternity Record System (SMR 2). RESULTS: We attempted to mail a total of 5540 women; 3752 (68%) returned a completed questionnaire. Of these 86% reported having had at least one birth. Linkage to SMR 2 was attempted for 5634 women, one or more maternity records were found for 3743. There were 2604 women who reported at least one birth in the questionnaire and who were linked to one or more SMR 2 records. When judged against the questionnaire information, the linkage correctly identified 4930 births and missed 601 others. These mostly occurred outside of Scotland (147) or prior to full coverage by SMR 2 (454). There were 134 births incorrectly linked to SMR 2. CONCLUSION: Probabilistic record linkage to routine maternity records applied to population-based cohort, using name, date of birth and place of residence, can have high specificity, and as such may be reliably used in epidemiological research.

Adolescent↗
PubMed1998

HIV-1 infection and reproductive history: a retrospective study among pregnant women, Abidjan, Côte d'Ivoire, 1995-1996. Ditrame Project.

The aim of this paper is to determine the differences of fertility between HIV-1 infected and uninfected women in Abidjan, Côte d'Ivoire, using data available in an observational study conducted in 1995 and 1996 in 2 antenatal care centres in the district of Yopougon, Abidjan, within an intervention programme to reduce mother-to-child HIV-1 transmission (DITRAME project, ANRS 049). Fertility indicators have been constructed from retrospective data on pregnancies and births, and univariate and multivariate analyses have been performed on these indicators and stratified by age groups to compare HIV-1 positive and HIV-negative populations. The main outcome measures were the number of pregnancies, the number of miscarriages, the risk of miscarriage and the proportion of primigravida. Four thousand, three hundred and ninety-six women agreed to HIV testing: 12.1% were found to be HIV-1 infected. HIV-1 positive women had significantly fewer pregnancies than HIV-negatives in age-groups 25-29 (P = 0.05) and 30-34 (P = 0.008). The risk of having had at least one abortion or stillbirth was significantly higher for HIV-1 infected women than for HIV-negatives (OR = 1.28, 95% CI: 1.02-1.60), when controlling for social and demographic factors. This study suggests that HIV-1 infection has deleterious consequences on female fertility, with lower fertility rates and more frequent adverse pregnancy outcomes. Family planning and antenatal care services should consider antenatal HIV counselling and testing in women in areas of high HIV prevalence.

Adult↗
PubMed1986

Characteristics of women with recurrent spontaneous abortions and women with favorable reproductive histories.

Women with a history of recurrent spontaneous abortions (repeaters) are compared with women who have had live births and no spontaneous abortions (multiparae) and women who have had live births and only one spontaneous abortion (sporadics) to identify characteristics of the women and their abortuses that might predict subsequent fetal loss. A number of risk factors for recurrent spontaneous abortion have been identified: the loss of a chromosomally normal conception, loss after the first trimester of pregnancy, a delay in conceiving prior to the study pregnancy, a diagnosis of cervical incompetence, and a history of very low birthweight deliveries. The odds ratios associated with being a repeater vary from 1.4 to 5.6 depending on the number of characteristics present.

Abortion, Habitual↗
PubMed1991

Knowledge of diagnosis and reproductive history among survivors of childhood plumbism.

As part of a study of the long-term consequences of childhood plumbism, 35 survivors of lead poisoning in the period 1930 through 1944 were interviewed along with 22 controls matched for age, sex, and town of residence. Subjects were asked to recall all pregnancies they engendered (men) or carried (women), outcome, and intellectual development of resulting children. Matched female plumbism subjects reported a higher proportion of spontaneous abortion or stillbirths among pregnancies (relative risk = 1.60, 95% confidence interval [CI] = 0.6-4.0) and a higher proportion of learning disabilities among school-age children (relative risk = 3.0, 95% CI = 0.9-10.2) in comparison with their controls. There was no evidence of clustering of learning disabilities within families or confounding by parental educational level. These results suggest that women with a history of childhood lead poisoning may be at risk for having spontaneous abortions or stillbirths and having children who manifest significant learning disabilities.

Abortion, Spontaneous↗
PubMed1993

Reproductive history, glucose tolerance, and NIDDM in Hispanic and non-Hispanic white women. The San Luis Valley Diabetes Study.

OBJECTIVE: To ascertain whether childbearing would decrease oral glucose-stimulated insulin and C-peptide levels and increase the risk of NIDDM and impaired glucose tolerance in a population of Hispanic and non-Hispanic white women residing in the San Luis Valley of Colorado. Several investigators have related childbearing to subsequent abnormal glucose tolerance. RESEARCH DESIGN AND METHODS: In a population-based case-control epidemiological study, diabetic patients 20-74 yr of age (n = 196) and randomly sampled control women subjects (n = 735) underwent a glucose tolerance test, a physical examination, and an in-person standardized interview. The relations between the live-birth number and fasting and oral glucose stimulated glucose, insulin and C-peptide concentrations, and NIDDM and impaired glucose tolerance were estimated using linear or logistic regression to adjust for extraneous variables. RESULTS: In women selected as control subjects, the live-birth number was related to a significant decrease in the sum of 1- and 2-h C-peptide concentrations (coefficient = -0.077, P < 0.001) and the logarithm of the sum of 1- and 2-h insulin concentrations (coefficient = -0.014, P = 0.02). After adjustment for subscapular skin-fold thickness, the relative odds of NIDDM for the live-birth number, which was small and of borderline significance, diminished (odds ratio = 1.04 for one birth, P = 0.18). Findings were similar for impaired glucose tolerance. CONCLUSIONS: Childbearing was related to lower C-peptide and insulin levels in Hispanic and non-Hispanic women of the San Luis Valley. It had little apparent effect on later risk of NIDDM or impaired glucose tolerance.

Adult↗
PubMed1990

The frequency of aneuploidy in cultured lymphocytes is correlated with age and gender but not with reproductive history.

The clinical significance of low numbers of aneuploid cells in routine cytogenetic studies of cultured lymphocytes is not always clear. We compared the frequencies of chromosome loss and gain among five groups of subjects whose karyotypes were otherwise normal; these groups were (1) subjects studied because of multiple miscarriages, (2) parents of live borns with autosomal trisomy, (3) subjects studied because they had a relative with Down syndrome, (4) an age-matched control group of phenotypically normal adults studied for other reasons (e.g., parent of a dysmorphic child or member of a translocation family), and (5) other mostly younger and phenotypically abnormal subjects who could not be assigned to the first four groups (e.g., individuals with multiple congenital anomalies or mental retardation). No significant age, sex, or group effects were observed for autosomal loss (hypodiploidy) or gain (hyperdiploidy). Autosomal loss was inversely correlated with relative chromosome length, but autosomal gain was not. Sex-chromosome gain was significantly more frequent in females than in males, but sex-chromosome loss was not significantly different between the sexes. Significant age effects were observed for both gain and loss of sex chromosomes. When age and sex were accounted for, the frequencies of sex-chromosome loss and gain were not significantly different among the five clinical groups. In general, low numbers of aneuploid cells are not clinically important when observed in blood chromosome preparations of subjects studied because of multiple miscarriages or a family history of autosomal trisomy.

Abortion, Spontaneous↗