Length In Women Research Articles

Pain is associated with short leukocyte telomere length in women with fibromyalgia

Telomere length is considered a marker of biological aging that is linked to an increased risk for morbidity and mortality. Psychosocial factors (e.g., depression, anxiety, obesity, trauma) are associated with shortened telomeres; factors all common in chronic pain. The objective of this study was to evaluate the role of pain in leukocyte telomere length in 66 women with fibromyalgia and 22 healthy female controls. Participants completed questionnaires and a subgroup of fibromyalgia patients underwent quantitative sensory testing (QST; n=12) and neuroimaging (voxel-based morphometry; n=12).

Cervical-vaginal fluid elafin concentrations and subsequent cervical shortening in women at high risk of spontaneous preterm birth

IntroductionElafin, a natural antimicrobial peptide, is an important component of the innate immune system. It is hypothesised that elafin production in cervico-vaginal fluid (CVF) will be altered in women at...

Physical Activity, Sedentary Behavior, and Leukocyte Telomere Length in Women

Leukocyte telomere length (LTL) is a potential indicator of cellular aging; however, its relation to physical activity and sedentary behavior is unclear. The authors examined cross-sectionally associations among activity, sedentary behavior, and LTL among 7,813 women aged 43-70 years in the Nurses' Health Study. Participants self-reported activity by questionnaire in 1988 and 1992 and sedentary behavior in 1992. Telomere length in peripheral blood leukocytes, collected in 1989-1990, was measured by quantitative polymerase chain reaction. The least-squares mean telomere length (z-score) was calculated after adjustment for age and other potential confounders. For total activity, moderately or highly active women had a 0.07-standard deviation (SD) increase in LTL (2-sided P(trend) = 0.02) compared with those least active. Greater moderate- or vigorous-intensity activity was also associated with increased LTL (SD = 0.11 for 2-4 vs. <1 hour/week and 0.04 for ≥7 vs. <1 hour/week; 2-sided P(trend) = 0.02). Specifically, calisthenics or aerobics was associated with increased LTL (SD = 0.10 for ≥2.5 vs. 0 hours/week; 2-sided P(trend) = 0.04). Associations remained after adjustment for body mass index. Other specific activities and sitting were unassociated with LTL. Although associations were modest, these findings suggest that even moderate amounts of activity may be associated with longer telomeres, warranting further investigation in large prospective studies.

Educational attainment and mean leukocyte telomere length in women in the European Prospective Investigation into Cancer (EPIC)-Norfolk population study.

Telomere length has been postulated as a marker of biological aging. Recent evidence has suggested that educational attainment but not social class is associated with telemore length. We investigated the associations between educational attainment, social class and relative mean telomere length in an ethnically homogeneous population of 4441 women, aged 41-80 years. Mean telomere length was measured using high-throughput quantitative Real Time PCR. Educational attainment (p=0.015) but not social class (p=0.61) was associated with mean telomere length in these data. This association was independent of social class and of systolic blood pressure, high-density lipoprotein cholesterol, cigarette smoking, body mass index, glycated hemoglobin, plasma vitamin C and physical activity (p=0.014), and was not attenuated through additional adjustment for measures of social adversity, including those experienced during childhood (p=0.006). Our results, at least for women, provide support for the findings previously reported in this journal that lower educational attainment, but not social class, is associated with shorter telomere length.

Abstract B112: Physical activity, sedentary behavior, and leukocyte telomere length in women

Abstract Telomeres are repetitive DNA-protein complexes that protect the ends of linear chromosomes and maintain genomic stability. They undergo erosion with each cycle of cell division, and oxidative stress and inflammation accelerate this shortening. Critically short telomeres may lead to several processes implicated in carcinogenesis, including chromosomal degradation, end-to-end fusion, and atypical recombination. Telomere length in peripheral blood leukocytes (PBLs) is a potential indicator of cellular aging and shortened leukocyte telomere length (LTL) has been linked to an increased risk of various cancer types, such as bladder, lung, and renal-cell. Regular physical activity reduces the risk of developing many cancers, and studies have observed lower levels of oxidative stress and inflammation in regularly active individuals. However, few population-based studies have examined the relation between physical activity and LTL, and none has addressed sedentary behavior. In addition, information is scarce on the role of exercise intensity and type in this relation. The authors therefore examined cross-sectionally the association between physical activity, sedentary behavior, and LTL among 7,813 women ages 43–70 in the Nurses' Health Study. Participants self-reported activity by questionnaire in 1988 and 1992, and sedentary behavior in 1992. Telomere length in PBLs, collected in 1989–1990, was measured by quantitative polymerase chain reaction. Least squares mean telomere length (z-score) was calculated after adjustment for age and other potential confounders. Total activity was positively associated with LTL. Compared with the least active women, those moderately or highly active had a 0.07 standard deviation (SD) increase in LTL (p-trend=0.02), a difference corresponding on average to 4.4 years of aging. Greater moderate-or vigorous-intensity activity was also associated with increased LTL; women who exercised 2–4 hours per week, an amount corresponding to current US guidelines, had the longest telomeres (0.11 SD increase for 2–4 vs. &amp;lt;1 hours/week; 0.04 SD increase for 7+ vs. &amp;lt;1 hours/week; p-trend=0.02). Among the individual activities, greater calisthenics or aerobics was associated with longer telomeres (0.10 SD increase for &amp;gt;2.5 vs. 0 hours/week; p-trend=0.04). Associations remained after additionally adjusting for body mass index. Time spent on other activities and time spent sitting were unassociated with LTL. Although associations were modest, these findings suggest that even moderate amounts of activity may be associated with longer telomeres, providing insight into the understanding of how exercise may influence cancer risk on the cellular level. These findings warrant further investigation in large prospective studies. Citation Information: Cancer Prev Res 2011;4(10 Suppl):B112.

Cervical Length Measurement for the Prediction of Preterm Birth in Multiple Pregnancies: A Systematic Review and Bivariate Meta-Analysis

Transvaginal sonography of the cervix can identify pregnancies at increased risk for preterm birth in both symptomatic and asymptomatic pregnant women. A previous randomized controlled trial has shown that vaginal progesterone is effective in preventing preterm birth in singleton women with asymptomatic cervical shortening during the second trimester. Randomized trials in women with multiple pregnancies have failed to show a significant reduction in preterm birth after treatment with progesterone. Overdistention of the cervix in previous pregnancies may limit the predictive value of cervical length measurement during the second trimester for preterm birth in multiple pregnancies. The aim of this meta-analysis was to review the predictive value of cervical length assessment for preterm birth in asymptomatic women with multiple pregnancies. The investigators conducted electronic searches of MEDLINE and Embase for published articles to 2009 as well as searches of reference lists of relevant articles not found with the electronic search. Two-by-two tables cross-classifying cervical length and gestational age were constructed from articles to score extracted descriptive data and study characteristics. The meta-analysis used a bivariate regression model analysis to construct summary receiver-operating characteristic (ROC) curves estimating sensitivity and specificity for changes in cervical length. A total of 21 studies involving 2757 women were identified Although there was a large variation in the gestational age, cutoff points of cervical length, and the exact definition of preterm birth, summary ROC curve estimates indicated that progressive shortening of cervical length was a good predictor of preterm birth before 34 weeks of gestation. ROC summary estimates showed sensitivity and specificity of 78% and 66%, respectively, at a cervical length of 35 mm, 41% and 87% at 30 mm, 36% and 94% at 25 mm, and 30% and 94% at 20 mm. These findings show that assessment of second-trimester cervical length in women with multiple pregnancies is a strong predictor of preterm birth.

Associations between Rotating Night Shifts, Sleep Duration, and Telomere Length in Women

BackgroundTelomere length has been proposed as a marker of aging. However, our knowledge of lifestyle risk factors determining telomere length is limited.MethodsWe evaluated the associations between years of rotating night shifts, self-reported sleep duration, and telomere length in 4,117 female participants from the Nurses' Health Study. Telomere length in peripheral blood leukocytes was determined by Real-Time PCR assay. Information on rotating night shifts and sleep duration was collected via questionnaires prior to blood collection. We used multivariable linear regression to investigate the associations between rotating night shifts, sleep duration, and telomere length.ResultsCompared with women in the category (9 hours), those in the lowest category of sleep duration (≤6 hours) had a 0.12 unit decrease in z score after adjustment for age, BMI and cigarette smoking (equivalent to 9-year telomere attrition, P for trend = 0.05). Significant positive association between sleep duration and telomere length was seen among women under age of 50 (P for trend = 0.004), but not among those over 50 (P for trend = 0.33) (P for interaction = 0.005). In addition, we observed that women with a longer history of rotating night shifts tended to have shorter telomere length, but this relation was not statistically significant (P for trend = 0.36).ConclusionWe found that sleep duration was positively associated with telomere length among women under 50 years old. Further research is needed to confirm the observed associations.

Sonographic cervical length measurement in pregnant women with a cervical pessary

The aims of this study were to describe and assess the feasibility of measuring cervical length by standard transvaginal sonography (TVS) and transperineal sonography (TPS) in women with a cervical pessary and compare these measurements with those obtained with a new transvaginal technique. Measurement of cervical length by TPS was attempted immediately before measurement using TVS in 48 women with a cervical pessary at between 22 and 23 weeks' gestation. The TVS procedure consisted of two types of measurement: in the first, the probe was placed on the anterior fornix (standard technique) and in the second, the probe was inserted into the pessary to touch the anterior cervical lip (new technique). Two physicians consecutively performed these procedures and compared the measurements obtained. Intraclass correlation coefficients (ICCs) with 95% CI were used to evaluate interobserver reliability, and Bland-Altman analysis was used to assess interobserver agreement. In total, 258 measurements (obtained from 43 women) were analyzed. Interobserver ICCs of the measurements obtained were 0.58 (95% CI, 0.34-0.75) for TPS, 0.65 (95% CI, 0.44-0.79) for the standard TVS technique and 0.97 (95% CI, 0.95-0.98) for the new TVS technique. Bland-Altman analysis showed small mean differences between measurements obtained by two physicians for the three methods, but with narrower limits of agreements (LOA) for the new TVS technique: TPS mean difference - 0.99 mm (95% LOA, - 13.23 to 11.25 mm), standard TVS technique mean difference - 0.23 mm (95% LOA, - 10.90 to 10.44 mm) and new TVS technique mean difference - 0.01 mm (95% LOA, - 2.57 to 2.55 mm). It was apparent from the images obtained that the external os was not visible in 89% of cases when either the TPS or standard TVS technique was used. However, the external os was visible in all cases when the new TVS method was used. We propose a new technique for measuring and monitoring cervical length in women with a cervical pessary that provides improved visualization of the cervix and increased reliability in comparison to established techniques.

Employment and work schedule are related to telomere length in women

ObjectivesTo examine the association of employment and work schedule with shorter DNA telomeres, a marker of cellular ageing and disease risk factor, and consider whether differences were related to health,...

Telomere Shortening in Formerly Abused and Never Abused Women

Recent studies suggest that chronic psychological stress may accelerate aging at the cellular level. Telomeres are protective components that stabilize the ends of chromosomes and modulate cellular aging. Women exposed to intimate partner violence (IPV) experience chronic stress and report worse health. The purpose of this exploratory study was to examine telomeric DNA length in women who have experienced chronic stress related to IPV. We hypothesized that IPV exposure would be associated with shorter telomere length. The investigation used a cross-sectional design to study telomere length in women with a history of IPV exposure and control women who reported no prior exposure to IPV. Advertisements and public notices were used to recruit a convenience sample of healthy women. Mean leukocyte telomere length was measured in DNA samples from peripheral blood mononuclear cells (PBMCs) by a quantitative polymerase chain reaction assay (qPCR). Telomere length was significantly shorter in the 61 formerly abused women compared to the 41 controls (t = 2.4, p = .02). Length of time in the abusive relationship and having children were associated with telomere length after controlling for age and body mass index (BMI) (F(2, 99) = 10.23, p < .001). Numerous studies suggest that women who experience IPV have poorer overall health. It is often presumed that the stress of IPV may be causing greater morbidity. Findings from this descriptive study suggest a link between IPV exposure, duration of IPV-related stress, and telomere length molecular mechanisms that regulate cellular aging.

Maternal Labor Market Return, Parental Leave Policies, and Gender Inequality in Housework

This study investigates how the duration of the work interruption and the labor market status of mothers upon their return affect the division of housework in couples after a birth. By observing several parental leave policy reforms in Britain and West-Germany, this research also explores how extended leave entitlements for mothers influence the division of housework. The analysis uses multilevel multiprocess models for 1220 birth events of British couples and 1785 births to German couples based on data from the British Household Panel Survey (1991-2008) and the German Socio-Economic Panel (1985-2009). The results suggest that mothers increase their housework hours with every additional month of employment interruption. Mothers’ full-time return seems more effective than a short labor market time-out in altering men’s housework contributions and reducing the trend towards a more traditional division of housework. Parental leave policy extensions for mothers were associated with the division of housework only indirectly through their impact on the length of women’s work interruptions.

Midtrimester bacterial vaginosis and cervical length in women at risk for preterm birth

Midtrimester bacterial vaginosis and cervical length in women at risk for preterm birth

Midtrimester bacterial vaginosis and cervical length in women at risk for preterm birth

The purpose of this study was to estimate the effect of bacterial vaginosis on midtrimester cervical length in women at increased risk for recurrent spontaneous preterm birth. We conducted a secondary analysis of prerandomization data from a multicenter trial of ultrasound-indicated cerclage. Women with previous spontaneous preterm birth at <34 weeks' gestation underwent initial cervical length assessment and vaginal fluid collection at 16-21 weeks 6 days gestation. Gram stains were scored with Nugent criteria. With serial scans, the shortest cervical length was observed. Records for 949 women had complete data. In unadjusted regression models, Nugent score (P = .003) and vaginal fluid pH (P = .008) were related inversely to cervical length. Women with bacterial vaginosis based on Nugent score ≥7 (P = .04) or pH ≥5 (P = .016) had significantly lower cervical length than unaffected women; however, all of these effects were null after covariate adjustment. Nugent score, pH level, and bacterial vaginosis are associated inversely with cervical length; however, these relationships become null after adjustment for relevant covariates.

Ultrasonographic Cervical Length and Risk of Hemorrhage in Pregnancies With Placenta Previa

Placenta previa in pregnancy can lead to massive hemorrhage and premature birth and is a leading cause of maternal morbidity and mortality. A clear relationship between ultrasonographic cervical length and preterm birth has been demonstrated, especially among women with a previous preterm birth. In unselected populations, a cervical length cutoff of 30 mm has been associated with nearly a 4-fold relative risk for preterm birth. Only limited data are available on cervical length in women with placenta previa. This prospective study was designed to estimate the relationship between third-trimester cervical length and subsequent hemorrhage and preterm birth among women with placenta previa. Between 2007 and 2009, the investigators performed transvaginal cervical-length measurements on all singleton pregnancies with placenta previa identified by ultrasound at or beyond 24 weeks of gestation. Only women with confirmed placenta previa at delivery were included. Short cervical length was defined as 30 mm or less. All clinicians and patients were blinded as to cervical-length measurements. A total of 89 women with placenta previa were identified; of these, 68 (76%) had placenta previa at delivery, and 29 (43%) had cervical lengths 30 mm or less. There were no differences in the gestational age of the 2 groups at cervical length assessment (short cervix: 32 weeks vs. longer cervix: 33 weeks; P = 0.4). Among women with placenta previa, delivery for hemorrhage was more likely with a short cervix than a longer cervix (79% vs. 28%); women with a short cervix were also more likely to require delivery preterm (69% vs. 21%; P 30 mm were more likely to deliver at term without no bleeding or hospitalization (64% vs. 17%; P< 0.001). These findings show that women with placenta previa who have a third-trimester cervical length of 30 mm or less are at increased risk for hemorrhage, uterine contractions, and preterm birth compared to women who have a longer cervix.

OC17.02: Cervical bacterial colonization and cervical length in women with threatening preterm labor

OC17.02: Cervical bacterial colonization and cervical length in women with threatening preterm labor

Ultrasonographic Cervical Length and Risk of Hemorrhage in Pregnancies With Placenta Previa

To estimate the relationship between cervical length and hemorrhage leading to preterm delivery in women with placenta previa. Between October 2007 and May 2009, transvaginal cervical-length measurements were obtained in all singleton pregnancies with placenta previa identified at or beyond 24 weeks of gestation. Only women who delivered liveborn or stillborn neonates at our hospital and had placenta previa confirmed at delivery were included. Cervical length of 30 mm or less was considered short. Clinicians were blinded to cervical-length measurements. Chi-square and logistic regression were used for analysis. Of 89 identified women with placenta previa at initial ultrasonography, 68 had placenta previa at delivery, and 29 (43%) of these had a short cervix. Gestational age at cervical-length measurement was 32+/-4 weeks in women with a short cervix and 33+/-2 weeks in those with a longer cervix (P=.4). Women with previa and a short cervix were more likely to require delivery for hemorrhage, 79% compared with 28%, and to deliver preterm, 69% compared with 21% (both P<.001). Tocodynamometer evidence of regular uterine contractions was more common with a short cervix than with a longer cervix, 69% compared with 21% (P<.001). Conversely, 64% with a cervical length greater than 30 mm had no bleeding episodes and progressed to term. In pregnancies with placenta previa, a third-trimester cervical length of 30 mm or less is associated with increased risk for hemorrhage, uterine activity, and preterm birth. II.

Does midtrimester cervical length ≥25 mm predict preterm birth in high-risk women?

We sought to assess pregnancy outcome along a continuum of cervical lengths (CLs) ≥25 mm. We conducted planned secondary analysis of a randomized cerclage trial of women with prior spontaneous preterm birth 17(0)-34(6/7) weeks. Outcomes of women who maintained CLs ≥25 mm were analyzed. Women with CLs <25 mm randomized to no cerclage comprised an internal comparison group. Of 1014 screened, 153 had CL <25 mm, and 672 had CL ≥25 mm. Birth <35 weeks occurred in 16% of the ≥25 mm cohort. The relationship between CLs ≥25 mm and birth gestational age was null (P = .15). In the <25 mm group, progressively shorter CLs predicted birth <35 weeks (P < .001); this relationship was null in the ≥25 mm group (P = .17). The continuum of CLs ≥25 mm measured between 16(0/7)-22(6/7) weeks does not predict gestational length in women with prior spontaneous preterm birth.

Gestational age at previous preterm birth does not affect cerclage efficacy

The purpose of this study was to evaluate the effect of earliest previous spontaneous preterm birth (SPTB) gestational age on cervical length, pregnancy duration, and ultrasound-indicated cerclage efficacy in a subsequent gestation. Planned secondary analysis of the National Institute of Child Health and Human Development-trial of cerclage for cervical length of <25 mm. Women with at least 1 previous SPTB between 17-33 weeks 6 days of gestation underwent serial vaginal ultrasound screening between 16 and 23 weeks 6 days of gestation; cervical length at qualifying randomization evaluation was used. We observed a significant correlation (P = .0008) between previous SPTB gestational age and qualifying cervical length. In a linear regression model that was controlled for cervical length and cerclage, neither previous SPTB gestational age nor the interaction between cerclage and previous birth gestational age was significant predictor of subsequent birth gestational age. Although there is an association between previous SPTB gestational age and cervical length in women with a mid-trimester cervical length of <25 mm, there does not appear to be a disproportionate benefit of cerclage in women with earlier previous SPTB.

Cervical sonography in pregnant women with a prior cone biopsy or loop electrosurgical excision procedure

To determine if pregnant women with a prior cone biopsy or loop electrosurgical excision procedure (LEEP) have a shorter midtrimester cervical length than do matched controls without a history of cervical surgery. Eighty-five pregnant women with a singleton gestation and previous cone biopsy or LEEP and 85 controls matched by age (± 5 years), race, gestational age (± 2 weeks), and number of prior vaginal deliveries underwent a single transvaginal cervical sonographic scan at 15-22 weeks' gestation. No patient had a cerclage in either group. Mean cervical length was significantly shorter in the cone biopsy/LEEP group (3.3 vs. 3.9 cm, P < 0.001), with no significant difference in the proportion of cervical lengths less than 2.5 cm (5.9 vs. 2.4%). Gestational age at delivery was slightly but significantly lower in the cone biopsy/LEEP group (38.1 vs. 39.1 weeks, P = 0.005) than in the control group, with a higher proportion of women delivering late preterm and very preterm in the cone biopsy/LEEP group. However, no woman with a prior cone biopsy/LEEP experienced a midtrimester loss suggestive of cervical insufficiency, and no patient with a cervical length less than 2.5 cm delivered before 34 weeks' gestation. Midtrimester cervical length in women with a previous cone biopsy or LEEP is significantly shorter than in those without prior cervical surgery. Based on the low frequency of a short cervix or midtrimester loss in women with prior excisional surgery, the routine use of midtrimester cervical sonography in such women is not supported.

Associations between diet, lifestyle factors, and telomere length in women

Leukocyte telomere length is associated with diseases of aging, but there is limited knowledge of diet and lifestyle determinants. The objective was to examine cross-sectionally the association between diet, body composition, and lifestyle factors on leukocyte telomere length in women. Leukocyte telomere length was measured by quantitative polymerase chain reaction in 2284 female participants from the Nurses' Health Study, who were selected as controls for an investigation of biological predictors of cancer. Diet, lifestyle, and anthropometric data were assessed by questionnaire. After multivariate adjustment, dietary fiber intake was positively associated with telomere length (z score), specifically cereal fiber, with an increase of 0.19 units between the lowest and highest quintiles (P = 0.007, P for trend = 0.03). Although total fat intake was not associated with telomere length, polyunsaturated fatty acid intake (-0.26 units, quintile 5 compared with quintile 1: P = 0.002, P for trend = 0.02), specifically linoleic acid intake, was inversely associated with telomere length after multivariate adjustment (-0.32 units; P = 0.001, P for trend = 0.05). Waist circumference was inversely associated with telomere length [0.15-unit difference in z score in a comparison of the highest (> or = 32 in, 81.28 cm) with the lowest (< or = 28 in, 71.12 cm) category (P = 0.01, P for trend = 0.02) in the multivariate model]. We found no association between telomere length and smoking, physical activity, or postmenopausal hormone use. Although the strength of the associations was modest in this population of middle- and older-age women, our results support the hypothesis that body composition and dietary factors are related to leukocyte telomere length, which is a potential biomarker of chronic disease risk.