An estimate of neonatal tetanus mortality in Iceland, 1790-1839.
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Age Factors↗
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The impact of children on divorce risks of Swedish women.
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Age Factors↗
Trends in marriage formation in Sweden, 1971-1993.
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Birth Rate↗
Childbearing trends in Sweden 1961-1997.
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Birth Rate↗
Pathways to a third child in Sweden.
The transition from two to three children is investigated, using data on Swedish women's fertility behavior and labor force participation over a period of some 20 years ending in 1992/93. Two questions are examined: what is the relationship between working life and childbearing of two-child mothers? Are there differences in fertility between cohabiting and married couples? Several paths to the third child are identified, one of women with a university education and another of women with preference for more children, reflected by marriage after having the first or the second child or by persistent working experience followed by household work.
Birth Order↗
Predictive intervals for age-specific fertility.
A multivariate ARIMA model is combined with a Gamma curve to predict confidence intervals for age-specific birth rates by 1-year age groups. The method is applied to observed age-specific births in Norway between 1900 and 1995, and predictive intervals are computed for each year up to 2050. The predicted two-thirds confidence intervals for Total Fertility (TF) around 2010 agree well with TF errors in old population forecasts made by Statistics Norway. The method gives useful predictions for age-specific fertility up to the years 2020-30. For later years, the intervals become too wide. Methods that do not take into account estimation errors in the ARIMA model coefficients underestimate the uncertainty for future TF values. The findings suggest that the margin between high and low fertility variants in official population forecasts for many Western countries are too narrow.
Birth Rate↗
AIDS risk reduction strategies among United States and Swedish heterosexual university students.
Attitudes toward sex and condoms in the U.S. are more negative and less monolithic than in Sweden. We investigated the possible effect of this on AIDS prevention strategies by comparing women and men who were heterosexual university students in the two countries (Sweden: n = 570; U.S.: n = 407). Using self-administered questionnaires, subjects were asked about their sexual activities, safer sex practices, numbers of partners, and condom use. American students took a more multifaceted approach to safer sex--combining changes in sexual activities, reductions in casual sex, and increased condom use with both steady and nonsteady partners. Swedish students took a more singular approach--consistently using condoms with nonsteady partners. It is suggested that the difference in Swedish practices results from fundamental differences in sexual attitudes between the countries.
Acquired Immunodeficiency Syndrome↗
Reproductive rights and reproductive behavior. Clash or convergence of private values and public policies?
Using a rational scientific approach upholding public health values, this article notes experience gained from 25 years of cooperative transnational research on reproductive behavior. An overview of world population trends is followed by discussions of reproductive rights as a human right, the utility of acceptability studies of modern methods of fertility regulation, and findings from research on psychological responses to abortion, long-term developmental effects of compulsory pregnancy, and the use of incentives and disincentives to influence family size. There is also consideration of the clash between private values and public policy on reproductive behavior in the United States and the convergence achieved in Denmark and the Netherlands, where rates of unintended pregnancy are among the world's lowest.
Abortion, Legal↗
Risk of breast cancer in relation to reproductive factors in Denmark.
The effect of reproductive factors on breast cancer risk was evaluated in a population-based case-control study, including 1,486 breast cancer cases diagnosed over a one-year period in Denmark. They were identified from the files of the nationwide trial of the Danish Breast Cancer Co-operative group and the Danish Cancer Registry. The control group was an age-stratified random sample of 1,336 women from the general population. Data on risk factors were collected by self-administered (mailed) questionnaires. Significantly increased relative risks (RR) were associated with never being pregnant (RR = 1.47), an early terminated first pregnancy (RR = 1.43), and having a natural menopause after the age of 54 (RR = 1.67). Trends of decreasing risk were observed by increasing parity and age at menarche. These findings were independent of age at first full-term pregnancy which overall was not related to breast cancer risk, though a weak association appeared in women less than 50 years at diagnosis. The study confirmed that pregnancies must continue to term to offer protection against breast cancer.
Abortion, Induced↗
Cigarette smoking, alcohol consumption and risk of breast cancer in young women.
The possible association between cigarette smoking, alcohol consumption and the risk of development of breast cancer before the age of 45 was investigated by means of a population-based case-control study in Sweden and Norway. Information was obtained, by personal interview, from 422 (89.2%) of all eligible patients with breast cancer newly diagnosed between May 1984 and May 1985, and from 527 (80.6%) of all age-matched controls. The possible confounding effects of oral contraceptive (OC) use, education, and reproductive and several other factors were taken into account in multivariate analyses. No association was found between ever smoking (versus never smoking) and breast cancer (odds ratio 1.0; 95% confidence interval (CI) 0.8-1.3). Further, there was no relation between breast cancer and duration of smoking, age at start of regular smoking, length of time since the start of regular smoking, or number of cigarettes smoked per day. There was no significant interaction between smoking, use of OCs, parity, and breast cancer. A moderate or high current consumption of beer, wine, liquor or total alcohol did not increase the risk of breast cancer. An alcohol intake of 5 grams per day or more was associated with a decreased risk of breast cancer (odds ratio 0.6; 95% CI 0.4-0.9), but possible effects of a change in habits after diagnosis, of recall bias and of residual confounding, e.g. by dietary habits, need serious consideration.
Adult↗
A role for a new herpes virus (KSHV) in different forms of Kaposi's sarcoma.
Kaposi's sarcoma (KS) is a previously rare, tumour-like lesion of controversial biological nature. KS has since the early 1980s become frequent in patients with AIDS, particularly in homosexuals. KS is also endemic in Central Africa predominantly in otherwise healthy men but also in women and children. Recently, evidence for the presence of novel, herpes virus DNA sequences in more than 90% of AIDS Kaposi lesions (AKS) was presented. This DNA was identified using representational difference analysis (RDA) generating short, unique sequences with variable homology to several herpes virus, but no intact virus was recovered. If these DNA-sequences are also present in other, non-HIV-associated forms of Kaposi's sarcoma this would strongly suggest a specific, aetiopathological involvement of this putative new herpes virus in the pathogenesis of Kaposi's sarcoma, rather than a contamination of yet another opportunistic virus in immunosuppressed AIDS patients.
Acquired Immunodeficiency Syndrome↗
Geographic tongue during a year of oral contraceptive cycles.
The geographic tongue of a 23-year-old female student was examined daily for one year. The size, number and location of the lesions were recorded using transparent films. The phase of the oral contraceptive cycle appeared to have a marked effect on the initiation and duration of the circinate lesions, the tongue changes being severest on the 17th day of the cycle. There was a positive correlation between the subjective complaint and the clinical picture of the tongue.
Adult↗
Resistance to activated protein C, highly prevalent amongst users of oral contraceptives with venous thromboembolism.
OBJECTIVE: Inherited resistance to activated protein C (APC resistance), which is caused by a single point mutation in the factor V gene, is a frequent risk factor for venous thromboembolism. The aim of this study was to determine the prevalence of APC resistance and other coagulation disorders in fertile women with venous thromboembolism and also the risk factors these women had been exposed to in connection with thromboembolic events. DESIGN: A retrospective, case-control study of 36 month duration. SETTING: The study was carried out at Blekinge Hospital, Karlskrona, Sweden. SUBJECTS: The study population comprised 27 fertile women age 16-47 years with thromboembolic complications, referred to the department of Internal Medicine at Blekinge Hospital in Karlskrona during a 36-month period. RESULTS: APC resistance was found in 10 out of 27 women. APC resistance was associated with treatment with oral contraceptives in five out of six women and with pregnancy in one of seven women. All women with resistance to APC developed venous thrombosis in association with a predisposing situation (risk situation) such as surgery, trauma, immobilization, pregnancy, inflammatory state or the use of oral contraceptives. Amongst women not resistant to APC, all but one developed thrombosis in connection with a risk situation. CONCLUSION: APC resistance was found to be highly prevalent amongst fertile women with a history of thromboembolic complication occurring during their use of oral contraceptives.
Adolescent↗
Conventional or Li vasectomy: a questionnaire study.
OBJECTIVE: To compare pain, discomfort, complications and convalescence during and after vasectomy performed conventionally or using the Li 'no-scalpel' method. PATIENTS AND METHODS: Between March 1993 and May 1995, 256 men were vasectomized at two city hospitals in Copenhagen; half of the patients underwent the conventional technique at one hospital and the remaining half the Li method at the other. The two groups were matched for the time at which they underwent surgery and therefore for the duration of follow-up. A questionnaire was sent to all patients, in which they scored pain and discomfort using a 10 cm visual analogue scale (VAS). The reproducibility of measurements was tested on 10 patients who had answered the same questions 1.5-2 years earlier. RESULTS: Men vasectomized using the Li method experienced less pain at rest after the first week (P = 0.05) and less use of analgesics (P < 0.001), had fewer infections (P = 0.0015) and contacts with their physician (P = 0.0078) than those conventionally vasectomized. There were no significant differences between the groups for pain and discomfort during surgery and in the first week after vasectomy, frequency of bleeding, haematoma, oedema, granuloma, pain at activity, absence from work, vasectomy failure by sperm analysis, sexual activity and satisfaction with the cosmetic result (all P > 0.05). CONCLUSION: Vasectomy using the Li method reduced post-operative pain, the use of analgesics, the frequency of infections and contacts with a physician when compared with the conventional procedure.
Adult↗
Thrombotic diseases in young women and the influence of oral contraceptives.
OBJECTIVE: In the evaluation of the clinical impact of thrombotic diseases in young women, age-specific incidence rates must be calculated for both arterial and venous thrombotic diseases, but also the case-fatality rate and figures for the clinical consequences among those who survive thrombosis must be included. The aim of this analysis was to quantify the clinical impacts of both arterial and venous thrombotic diseases among young, nonpregnant women and thereafter to assess the influences of oral contraceptives on these measures. STUDY DESIGN: Nationwide register data on the morbidity and mortality of venous thromboembolism, myocardial infarction, and thrombotic stroke in Denmark, 1980-1993, and 3 ongoing case-control studies to assess the influence of oral contraceptives on the risk for development of these thrombotic diseases. RESULTS: In women 15-29 years old venous thromboembolism is about twice as common as arterial complications, whereas in women 30-44 years old the number of arterial complications exceeds that of venous diseases by about 50%. The mortality rate from arterial diseases is 3.5 times higher than that from venous diseases among women <30 years old and 8.5 times higher than that from venous diseases in women 30-44 years old. The proportion of women with a significant disability among women who had an arterial complication was about 30%; the proportion was about 5% among women with venous thromboembolism. CONCLUSION: Anticipating a differential influence on venous and arterial diseases from oral contraceptives with second- and third-generation progestogens, it was calculated that users of oral contraceptives with second-generation progestogens had 30% greater increased risk of thrombotic diseases, 260% greater increased risk of thrombotic deaths, and 220% greater increased risk of thrombotic disability than users of oral contraceptives with third-generation progestogens.
Adolescent↗
A prospective, one-year study on the effects of two long acting injectable contraceptives (depot-medroxyprogesterone acetate and norethisterone oenanthate) on serum and lipoprotein lipids.
Two parenterally administered progestins (depot medroxyprogesterone acetate, DMPA, 150 mg/12 weeks and norethisterone oenanthate, NET, 200 mg/8 weeks respectively) were given to women seeking contraceptive advice. Before treatment and after 1, 6, 7, 12 and 13 months blood samples were taken. In serum and in the ultracentrifugally separated lipoprotein fractions the levels of total and free cholesterol, triglycerides and phospholipids were assayed, as were the apolipoprotein A1 and B levels in serum. At the end of the study NET had induced a decrease in all lipid components of the HDL (high density lipoprotein) fraction of approximately 30% and tended to increase LDL (low density lipoprotein) lipids. DMPA also decreased HDL-lipids, approximately 15%. There was also a transient decrease in apolipoprotein A1 after one month in both patient groups. From epidemiological studies it is inferred that low HDL-levels and high LDL-levels are independent risk factors for the development of atherosclerosis and cardiovascular disease. Thus our findings might indicate an adverse effect in this respect of long term treatment with these progestins, particularly with NET.
Adult↗
Immunoreactive somatomedin B (RIA-B) in the circulation of healthy adults and patients with endocrine disorders.
The serum and cerebrospinal fluid (CSF) levels of immunoreactive somatomedin B (RIA-B) were examined throughout life in healthy adult humans. A significant decline in serum RIA-B was observed in subjects over 60 years of age. No significant diurnal, daily, or monthly serum variation was observed in healthy subjects aged 20-60 years. However, women taking oral contraceptives had elevated RIA-B values. No significant decline in CSF RIA-B was observed in subjects over 60 years of age. A significantly lower level of RIA-B in CSF was observed in subjects sampled at 20.00 h compared to subjects sampled in the morning. A significant decline in serum RIA-B was observed in patients with hypopituitarism and diabetes mellitus and a significant elevation of serum RIA-B levels was observed in patients with hyperthyroidism. CSF RIA-B was significantly elevated in patients with Cushing's syndrome.
Adult↗
Teratogenic aspects of abdominal wall defects.
The article describes two methods used to reveal possible teratogenic factors involved in the aetiology of abdominal wall defects. Forty-six mothers to children with gastroschisis and omphalocele were questioned about heredity, occupation, use of drugs etc. during early pregnancy (case history study). Seventy-four mothers to children with gastroschisis and omphalocele were randomly selected from a national register and their maternal health service record forms were studied and compared with the forms of 144 matched controls (case control study). None of the analyzed factors was found to be of significant teratogenic importance in the aetiology of abdominal wall defects, nor was it possible to explain the increase in the incidence of gastroschisis taking place during the early 70s.
Abdominal Muscles↗