Number Of Term Pregnancies Research Articles

Pregnancy outcomes in 1869 pregnancies in a large cohort from the Spanish Society of Rheumatology Lupus Register (RELESSER)

IntroductionObstetric complications are more common in women with systemic lupus erythematosus (SLE) than in the general population. ObjectiveTo assess pregnancy outcomes in women with SLE from the RELESSER cohort after 12 years of follow-up. MethodsA multicentre retrospective observational study was conducted. In addition to data from the RELESSER register, data were collected on obstetric/gynaecological variables and treatments received. The number of term pregnancies was compared between women with pregnancies before and after the diagnosis of SLE. Further, clinical and laboratory characteristics were compared between women with pregnancies before and after the diagnosis, on the one hand, and with and without complications during pregnancy, on the other. Bivariate and multivariate analyses were carried out to identify factors potentially associated with complications during pregnancy. ResultsA total of 809 women were included, with 1869 pregnancies, of which 1395 reached term. Women with pregnancies before the diagnosis of SLE had more pregnancies (2.37 vs 1.87) and a higher rate of term pregnancies (76.8% vs 69.8%, p < 0.001) compared to those with pregnancies after the diagnosis. Women with pregnancies before the diagnosis were diagnosed at an older age (43.4 vs 34.1 years) and had more comorbidities. No differences were observed between the groups with pregnancies before and after diagnosis in antibody profile, including anti-dsDNA, anti-Sm, anti-Ro, anti-La, lupus anticoagulant, anticardiolipin or anti-beta-2-glycoprotein. Overall, 114 out of the 809 women included in the study experienced complications during pregnancy, including miscarriage, preeclampsia/eclampsia, foetal death, and/or preterm birth. Women with complications had higher rates of antiphospholipid syndrome (40.5% vs 9.9%, p < 0.001) and higher rates of positivity for IgG anticardiolipin (33.9% vs 21.3%, p = 0.005), IgG anti-beta 2 glycoprotein (26.1% vs 14%, p = 0.007), and IgM anti-beta 2 glycoprotein (26.1% vs 16%, p = 0.032) antibodies, although no differences were found regarding lupus anticoagulant. Among the treatments received, only heparin was more commonly used by women with pregnancy complications. We did not find differences in corticosteroid or hydroxychloroquine use. ConclusionsThe likelihood of term pregnancy is higher before the diagnosis of SLE. In our cohort, positivity for anticardiolipin IgG and anti-beta-2- glycoprotein IgG/IgM, but not lupus anticoagulant, was associated with a higher risk of poorer pregnancy outcomes.

Associations of Parity With Change in Global Cognition and Incident Cognitive Impairment in Older Women.

BackgroundThe evidence of the association between parity and risk of mild cognitive impairment (MCI) or dementia is mixed, and the relationship between parity and longitudinal cognitive changes is less clear. We investigated these issues in a large population of older women who were carefully monitored for development of MCI and probable dementia.MethodsUsing the Women’s Health Initiative Memory Study, 7,100 postmenopausal women (mean age 70.1 ± 3.8 years) with information on baseline parity (defined as the number of term pregnancies), measures of global cognition (Modified Mini-Mental State Examination score) from 1996–2007, and cognitive impairment (centrally adjudicated diagnoses of MCI and dementia) from 1996–2016 were included. Multivariable linear mixed-effects models were used to analyze the rate of changes in global cognition. Cox regression models were used to evaluate the risk of MCI/dementia across parity groups.ResultsOver an average of 10.5 years, 465 new cases of MCI/dementia were identified. Compared with nulliparous women, those with a parity of 1–3 and ≥4 had a lower MCI/dementia risk. The HRs were 0.75 (0.56–0.99) and 0.71 (0.53–0.96), respectively (P < 0.01). Similarly, a parity of 1–3 and ≥4 was related to slower cognitive decline (β = 0.164, 0.292, respectively, P < 0.05).ConclusionHigher parity attenuated the future risk for MCI/dementia and slowed the rates of cognitive decline in elderly women. Future studies are needed to determine how parity affects late-life cognitive function in women.

Analysis of risk factors associated with breast cancer in women: a systematic review and meta-analysis.

BackgroundThe aim of the present study was to explore the risk factors and protective factors related to breast cancer onset in women, but there is still a big debate in this respect. Therefore, it is necessary to systematically review the risk factors induced by breast cancer by using meta methods to guide clinical prevention and treatment.MethodsStudies on factors related to breast cancer onset in Chinese women were retrieved from articles from Chinese, international databases published and organizations and websites, and registers from January 2014 to January 2021. Articles were independently screened, extracted, and evaluated for quality by 2 researchers. The Cochrane Collaboration Center provided Review Manger 5.2 software [Cochrane Information Management System (IMS)] for statistical analysis, and the risk ratio of dichotic variables was adopted.ResultsHistory of benign breast disease [odds ratio (OR) 1.03, 95% confidence interval (CI): 0.95–1.12, P=0.42], family history of breast cancer (OR: 2.02, 95% CI: 1.83–2.23, P<0.00001), menopause onset >50 years of age (OR: 1.78, 95% CI: 1.62–1.95, P<0.00001), and use of oral contraceptives (OR: 1.16, 95% CI: 1.02–1.32, P=0.02) were found to be breast cancer risk factors. The number of term pregnancies (OR: 0.80, 95% CI: 0.66–0.97, P=0.03) and breastfeeding (OR: 0.84, 95% CI: 0.74–0.96, P=0.01) were found to be protective factors for breast cancer.ConclusionsIn order to control the occurrence of breast cancer, effective measures should be taken to effectively avoid related risk factors, and breastfeeding and high-risk population screening should be advocated.

The role of colchicine treatment on reproductive outcome in women with Familial Mediterranean Fever

Öz&#x0D; Amaç: Bu çalışma, Ailevi Akdeniz Ateşi (AAA) tanısı alan ve kolşisin tedavisi verilen kadınların üreme sonuçlarını karşılaştırmak amacıyla planlandı.&#x0D; Gereç ve Yöntem: AAA tanılı 40 infertil kadın kolşisin tedavisi alıp almadığına bakılmaksızın iki gruba ayrıldı. 29 AAA hastası düzenli kolşisin tedavisi alırken, 11 hasta kolşisin tedavisi almıyordu. Hastalara tüp bebek kliniğimize başvurmadan önce AAA tanısı kondu. Tüm hastalar, hormonal profili, semen analizi ve histerosalpingografi (HSG) dahil olmak üzere baseline kısırlık incelemesine tabi tutuldu. Katılımcılara standart antagonist protokole göre ovulasyon stimülasyonu başlandı. Çalışmamızın birincil sonuç ölçütleri, klinik gebelik yüzdesi, abortus oranları, devam eden gebelik, canlı doğum ve term doğum oranları olarak belirlendi.&#x0D; Bulgular: HSG'de üç tür problem tespit ettik; (i) peritubal adezyon (ii) periovaryan adezyon ve (iii) hidrosalpinks. HSG'deki anormal bulgular nedeniyle 11 hastaya laparoskopi yapıldı. Kolşisin grubunda 8 olguda adezyon, kolşisin verilmeyen hastalarda ise 3 olguda adezyon tespit edildi. Kolşisin grubunda 8 vakada hidrosalpinks tespit edilirken, kolşisin almayanlarda sadece 1 vakada tespit edildi. Douglas poşundaki asit her iki grupta da ultrasonografi veya laparoskopi ile tespit edildi. Kolşisin almayan hastalarda, kolşisin alan hastalara göre klinik gebelik anlamlı derecede yüksek bulundu. Düşük oranları açısından iki grup arasında anlamlı fark yoktu. Kolşisin grubunda erken doğum oranları anlamlı olarak düşük bulunurken, zamanında doğum oranları kolşisin grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu.&#x0D; Sonuç: Term gebeliklerin sayısı üzerindeki olumlu etkisi dışında, kolşisin tedavisinin üreme sonuçları üzerinde herhangi bir olumsuz etkisi tespit edemedik.&#x0D; &#x0D; Abstract&#x0D; Aim: This study was planned to compare the reproductive outcome of women diagnosed with Familial Mediterranean Fever (FMF) who were given colchicine treatment and those who were not. &#x0D; Material and Method: Forty infertile women with FMF were divided into two groups whether they received colchicine treatment or not. While 29 FMF patients received regular colchicine treatment 11 patients did not receive colchicine treatment. The patients were diagnosed with FMF before applying to our IVF clinic. All patients were subjected to full infertility work-up, including hormonal profile, semen analysis and hysterosalpingography (HSG). All women with FMF were treated according to a standard antagonist protocol. The primary outcome measures were the percantage of clinical pregnancy (CPR), miscarraige rates, ongoing pregnancy, live birth and term birth rates. &#x0D; Results: We detected three types of problems in HSG; (i) peritubal adhesion (ii) periovarian adhesion and (iii) hydrosalpinx. Eleven patients underwent laparoscopy due to abnormal findings in HSG. Adhesion was detected in 8 cases in the colchicine group, while adhesion was detected in 3 cases in the patients who were not given colchicine. Hydrosalpinx was detected in 8 cases in the colchicine group, while it was detected in only one case in those who did not take colchicine. Ascites in the Douglas pouch was detected ultrasonographically or by laparoscopy in both groups. The CPR was found to be significantly higher in patients who did not receive colchicine compared to patients who received colchicine. There was no significant difference between two groups in terms of miscarraige rates. While preterm birth rates were found to be significantly lower in the colchicine group term birth rates were significantly higher in colchicine group compared to control group. &#x0D; Conclusion: Except for the positive effect on the number of term pregnancies we could not detect any negative effect of the colchicine treatment on the reproductive outcome.

Continuous Contraceptive Use Combined with Overweight or Obesity Triggers the Risk of Surgery Due to Leiomyomas

1. Abstract <span lang=ES style=font-size: 10.0pt;font-family: times= new= roman,serif=>Background: Uterine leiomyomas or fibroids are the most common bening tumours of the myometrium and the most common neoplasia of the female genital tract and being the most common indication for hysterectomy as the predominant treatment option. We have conducted a study in order to identify the hormonal factors associated with risk of uterine leiomyomas requiring surgery in premenopausal women. <span lang=ES style=font-size: 10.0pt;font-family: times= new= roman,serif=>Methods: Case-control study in a Caucasian spanish population conducted with women attending the gynecology departments of two hospitals in Canary Islands. A total of 577 women who underwent hysterectomy or myomectomy for uterine leiomiomas in a four years period at both hospitals were included as cases and 644 women with intact uteri and free of uterine leiomyoma as confirmed by ultrasound diagnosis served as control subjects. Age, menarche, number of term pregnancies, height, weight, history of oral contraceptive and in vitro fecundation treatment was recorded at baseline. For cases, gynaecological data include number of leiomyomas, location, size and diagnosis of polymyomatosis. Logistic regression equation was applied to estimate the chance of suffer surgery due to leiomyoma. <span lang=ES style=font-size: 10.0pt;font-family: times= new= roman,serif=>Results: In vitro fecundation increase 14 (95%CI: 8-21) times the risk of surgery due to uterine leiomyomas. Overweight and obesity increased the risk of surgery over 7 (95%CI: 4-11) and 11 (95%CI: 5-19) times respectively. Every month of contraceptive intake increases in 29% (95%CI: 5%-219%) the risk of surgery. Finally, the risk associated with ovarian activity was near 7 (95%CI:2-14) times and each additional year of age increases the risk or leiomioma surgery by 8% (95%CI:4%-9%). <span lang=ES style=font-size: 10.0pt;font-family: times= new= roman,serif=>Discussion: Based on our results, at age 50 the probability of surgery because leiomyomas for women with normal weight increases four times more than at 20 years old. Fixing the age, the probability of needing surgery increased from 50 to 60 percent for overweight to obese women. Fixing age and weight, after a year of contraception use the probability of surgery because leiomyoma raise to two-thirds, and is nearly 100% in case she is 50 years old and overweight or obese. <span lang=ES style=font-size: 10.0pt;font-family: times= new= roman,serif=>Conclusion: A ge increase, prolonged contraceptive use, in vitro fecundation, overweight and obesity, lead to a higher and more prolonged exposure of the uterus to steroid hormones, cumulative effect leading to increased risk of growth of already existing fibroid or the formation of new ones in those uteri at risk of developing leiomyomas, that contributes to increase the risk of surgery for fibroids. 2. Keywords : Uterine leiomyomas; Hysterectomy; Risk factors

Age at onset of multiple sclerosis is correlated to use of combined oral contraceptives and childbirth before diagnosis

The aim of this study was to evaluate whether age of onset of multiple sclerosis is related to use of combined oral contraceptives and/or timing of childbirth. The results showed that use of combined oral contraceptives and childbirth before the first multiple sclerosis symptom was correlated to a higher mean age at the onset of the disease.

Treatment of uterine leiomyomata by LH-RH agonists.

The rapid development and availability of luteinizing hormone releasing hormone (LH-RH) agonists have led to their widespread utilization in a variety of gynecologic conditions (McLachlan et al. 1986). One of the most common conditions in the practice of the gynecologist is uterine leiomyomata (Heinrichs 1991). Uterine leiomyomata are the most common solid tumor of the female genital tract and may bring about menometrorrhagia, pelvic pain and discomfort, anemia, infertility and habitual abortion (Blumenfeld et al. 1990; Esterday et al. 1983; Filicori et al 1983; Heinrichs 1991). Estrogens are known to play a major role in the development and enlargement of these tumors. High levels of estrogen receptors have been found in this type of tumor, and exogenous administration of estrogens may result in rapid increase in their size (Blumenfeld et al. 1990; Filicori et al. 1983; Heinrichs 1991; Tamaya et al. 1985; Wilson et al. 1980). The estrogen dependence is in agreement with the clinical observations that fibroids are most commonly diagnosed in women aged between 30 and 50 years, that fibroids tend to shrink after the menopause, and that fibroids can rapidly increase in size during pregnancy (Healy 1990). On the other hand, case-control analysis of 535 women who had had leiomyomata showed that the risk of leiomyomata was inversely correlated with the number of term pregnancies (Healy 1990; Ross et al. 1986). This suggested that low, unopposed estradiol (E2) levels, resulting from the several pregnancies and also the subsequent puerperia, reduced the growth of nascent leiomyomata (Healy 1990). The risk of developing leiomyomata was directly correlated with increasing duration of oral contraceptive use, lower body weight, and cigarette smoking (Healy 1990; Ross et al. 1986). Serum E2 concentrations in patients with uterine leiomyomata were similar to those in control women (Healy 1990; Soules and McCarthy 1982; Spellacy et al. 1972).

Personal and environmental characteristics related to epithelial ovarian cancer. I. Reproductive and menstrual events and oral contraceptive use.

In two case-control studies conducted in the six-county San Francisco Bay Area, 111 women diagnosed with epithelial ovarian carcinoma in 1974-1977 and 188 women diagnosed in 1983-1985 were interviewed concerning their menstrual, sexual, and reproductive histories. For comparison, interviews were conducted with 752 control women admitted to the same hospitals within six months of the cases; for cases diagnosed in the later period, interviews were also conducted with an additional 259 population-based controls selected by random digit dialing. Controls were matched to cases by age and race. Qualitative and quantitative findings were similar for the two studies. In the combined data, cases were more likely than their matched controls to have been nulliparous, to have undergone menarche at an early age, and to have refrained from using oral contraceptives. Menopause occurred slightly later for cases than for controls, but the differences were not statistically significant. Neither age at first term pregnancy (20 or more weeks gestation) nor number of term pregnancies was predictive of ovarian cancer risk. The protection afforded by oral contraceptive use was independent of parity, and it increased with increasing duration of use. There were no trends in risk with time since last oral contraceptive use or with time since first use, after adjustment for duration of use. These observations suggest that oral contraceptive use decreases risk for ovarian cancer, rather than merely indicates fertility, which may itself decrease risk of developing the disease. The authors combined reproductive characteristics and oral contraceptive use to estimate a woman's total duration of ovulation, which was positively associated with ovarian cancer risk (p less than 0.001 for trend). These observations support the concept that the greater the duration of ovulation or accompanying endocrinologic phenomena, the greater a woman's risk for ovarian cancer.

Implantation potential of each pre-embryo in multiple pregnancies obtained by in vitro fertilization seems to be different

Endometrial receptivity and pre-embryo quality are the main factors determining embryo implantation in in vitro fertilization. If one embryo implants normally and goes to term, the endometrium can be assumed to be normal. Eighty-one patients (March 1981 to 1987) had transfers of multiple pre-embryos, resulting in multiple pregnancies with at least one reaching term. The number of gestational sacs at 8 to 12 weeks of pregnancy, at 20 weeks, and the number of term pregnancies were studied longitudinally. Twelve patients (14.8%) had 2 pre-embryos transferred, 19 (23.5%) had 3, 21 (25.9%) had 4, 17 (21.0%) had 5, 9 (11.1%) had 6, and 3 (3.7%) had 7. At 20 weeks 18 patients (22.2%) had a single viable fetus, 56 (69.1%) had twins, 6 (7.4%) had triplets, and 1 (1.2%) had quadruplets. A total of 325 pre-embryos were transferred; 178 gestational sacs were observed at 8 to 12 weeks, but only 153 showed fetal heartbeat. Total embryo loss at 8 to 12 weeks was 53.0%; when the "index" embryo was excluded, it reached 61%. Regardless of the number of pre-embryos transferred, only 2.2 embryos on average were able to establish a normal pregnancy. (A)synchronism of the pre-embryos did not affect outcome. Results suggest that with normal endometrial receptivity, the implantation potential of each pre-embryo is different.

An Analysis of Macrosurgical and Microsurgical Techniques in the Management of the Tuboperitoneal Factor in Infertility

One hundred and sixty tubal reconstructions were analyzed according to a classification which describes the type of tubal repair and the tubal segment treated. The results in 80 women who were operated upon just prior to the application of microsurgical principles were compared with those in 80 women in whom these techniques were employed. In expressing the results, no patients were excluded for any reason. Anatomical patency was not evaluated, and functional patency was measured by conception (abortion, tubal, or term pregnancy). Of the 80 women who had tuboplasty with conventional surgery, 10 (12.5%) successfully delivered at term, but 14 (17%) had tubal gestations. Almost 28% of the women (22) had successful pregnancies after microsurgery, but in 9 (11%) extrauterine pregnancies resulted. The three women with current intrauterine pregnancies could improve the microsurgical series to 31% successful pregnancies. Our initial experience with microsurgical techniques seems to show an increased number of term pregnancies, principally in patients who have undergone anastomosis.

Inhibition of fertility in rabbits by administration of homologous placental extracts and human chorionic gonadotropin

Adult New Zealand white rabbits received large doses of HCG, with and without precedent administration of various homologous placental extracts. The all-or-none criterion of pregnancy was used to determine whether or not a fertility-inhibiting response could be elicited. Chronic administration of HCG alone did not reduce the pregnancy rate and none of the placental extracts generated a response, sufficient by itself, to interfere with pregnancy. However, when the injection of homologous material was followed by chronic administration of HCG, the number of term pregnancies was reduced by nearly one-half. There was a further reduction in term pregnancies when the rabbits were mated again after a four-month rest period.