Reproductive Risk Research Articles

Risk factors for breast cancer among women in Freetown, Sierra Leone, 2017: a case-control study.

breast cancer is the most commonly diagnosed malignancy and an important cause of cancer death among females worldwide. The disease accounted for 25% (1.67 million) of new cancer cases and the fifth cause of cancer deaths. Incidence of all types of cancers is approximately 25% in Sierra Leone. However, there was no documented evidence on risk factors for breast cancer among women in the country. The main aim of this study was to assess risk factors associated with breast cancer among women screened for breast cancer in Freetown Sierra Leone. we conducted a case-control study on breast cancer involving 116 confirmed breast cancer cases and 116 controls. Questionnaire was designed to collect data on socio-demographic, reproductive and behavioral risk factors. Analysis was carried using logistic regression to assess the associations between breast cancer and the risk factors. in the final multiple logistic regression, had formal educational level, (aOR 0.1, 0.03-0.26, p= 0.001) physical activity for more than 30 minutes per week (aOR 0.5 (0.9- 0.7, p=0.001). Cigarette smoking (aOR 4.8, 1.2-18.5, p=0.023) and family history of breast cancer (aOR 9.9 cigarette smoking (OR 4.4, 1.2-18.5, p=0.023) and family history of breast cancer (OR 9.9, 2.7-36.45, p=0.040) were identified as the main risk factors for breast cancer. This study did not find any statistically significant associations between reproductive risk factors and breast cancer. risk factors for breast cancer among women in Sierra Leone include educational level, physical activity, cigarette smoking and family history of breast cancer. We recommended screening program for women above 40 years and had history of breast cancer. Also, to establish breast cancer registry.

Factors related to Morbidity and Mortality in cases of Maternal death of the Mexican Social Security Institute of Sinaloa for the year 2021- 2022

Introduction: obstetric morbidity runs parallel to maternal mortality rates, so it is a way to evaluate the quality of care provided. Behind every maternal death lies a personal tragedy that can be resolved. The objective is to relate the factors of Maternal Morbidity and Mortality in cases of maternal death in the Mexican Social Security Institute, Sinaloa from 2021 to 2022.Method: study population integrated into a sample of 116 pregnant women from the IMSS Sinaloa, identified through the “PAMM” database and institutional records, associating sociodemographic variables, reproductive and prenatal risk factors, comorbidities in the pregnant stage and action protocols, achieving the creation of a logistic regression model. Non-probabilistic convenience sampling. Observational, analytical, retrospective and transversal research design.Results: the variables of pregestational care, BMI, transfer, place of occurrence, APP of DM2 and SAH, complications in previous pregnancies and immunization of COVID and influenza, explain maternal mortality by 55,2 % according to the Cox and Snell R2 coefficient.Conclusion: addressing the differences of the health institution by ethnicity, gender, social territory, life cycles will give the possibility of making visible the true scenarios behind a maternal death: Preconception risk factors and Specific Action Protocols

Calcium signaling in oocyte quality and functionality and its application.

Calcium (Ca2+) is a second messenger for many signal pathways, and changes in intracellular Ca2+ concentration ([Ca2+]i) are an important signaling mechanism in the oocyte maturation, activation, fertilization, function regulation of granulosa and cumulus cells and offspring development. Ca2+ oscillations occur during oocyte maturation and fertilization, which are maintained by Ca2+ stores and extracellular Ca2+ ([Ca2+]e). Abnormalities in Ca2+ signaling can affect the release of the first polar body, the first meiotic division, and chromosome and spindle morphology. Well-studied aspects of Ca2+ signaling in the oocyte are oocyte activation and fertilization. Oocyte activation, driven by sperm-specific phospholipase PLCζ, is initiated by concerted intracellular patterns of Ca2+ release, termed Ca2+ oscillations. Ca2+ oscillations persist for a long time during fertilization and are coordinately engaged by a variety of Ca2+ channels, pumps, regulatory proteins and their partners. Calcium signaling also regulates granulosa and cumulus cells' function, which further affects oocyte maturation and fertilization outcome. Clinically, there are several physical and chemical options for treating fertilization failure through oocyte activation. Additionally, various exogenous compounds or drugs can cause ovarian dysfunction and female infertility by inducing abnormal Ca2+ signaling or Ca2+ dyshomeostasis in oocytes and granulosa cells. Therefore, the reproductive health risks caused by adverse stresses should arouse our attention. This review will systematically summarize the latest research progress on the aforementioned aspects and propose further research directions on calcium signaling in female reproduction.

Effect of clinical whole exome sequencing in aetiological investigation and reproductive risk prediction for a couple with monogenic inherited diseases.

To determine the genetic causes of monogenic inherited diseases in a couple using clinical whole exome sequencing (WES) and advise on their reproductive choices. WES was applied to a couple seeking reproductive advice, the female with short stature and the male with congenital cataracts. (1) The woman exhibited a 13.8Kb heterozygous deletion at chrX: 591590-605428 (hg19). This region corresponds to exons 2-6 of the short-stature homeobox-containing (SHOX) gene (NM000451). Associated diseases involving the SHOX gene range from severe Leri-Weill dyschondrosteosis to mild nonspecific short stature. Meanwhile, further validation using a quantitative reverse transcription polymerase chain reaction assay confirmed the heterozygous deletion of the SHOX gene in the proband, as well as other family members with similar clinical characteristics (the proband's mother, aunt, and cousin). Multiple pathogenic reports of this variant have been included in the HGMD database. Per the American College of Medical Genetics and Genomics (ACMG) classification criteria, this deletion is classified as pathogenic. (2) For the male patient, a heterozygous variant was detected in the CRYBB3 gene: NM004076: c.226G>A (p.Gly76R). Variants in the CRYBB3 gene can cause Cataract 22 (OMIM: 609741). At present, this variant locus is not included in databases such as the gnomAD, while both SIFT and PolyPhen2 deem this locus 'damaging'. Moreover, further validation by Sanger sequencing confirmed that the variant was inherited from the male patient's mother, who also had cataracts. According to ACMG standards and guidelines, the c.226G>A (p.Gly76Arg) variant in the CRYBB3 gene is classified as having 'uncertain significance'. WES identified pathogenic variants in both individuals, suggesting a 25% chance of a healthy child naturally. Third-generation assisted reproductive techniques are recommended to minimize the risk of affected offspring.

High Reproductive Risk and Contraception

Background: Patients with high reproductive risk have important risk factors for the development of complications, including maternal death. Rejection of a method is influenced by various factors, including: biological, cultural and social factors. Objective: Identify the main sociocultural and demographic factors associated with not choosing a contraceptive method in women at high reproductive risk. Material and Methods: it is an observational, cross-sectional, analytical and prospective study with non-probabilistic sampling carried out in pregnant women with high reproductive risk who were offered contraception through a questionnaire. Results: 75 patients with high reproductive risk (20%) were included, with an average age of 27 years, occupation as a housewife (48%), living in an urban area (66.7%), complete primary schooling (22.67%), Catholic religion (72%), married (57.3%), middle class (72%); alcoholism in 2 patients (2.67%) and 2 other drugs (2.67%); 68% rejected contraception; for personal reasons (76.4%). A significant relationship was found with the Jehovah’s Witness religion (p = 0.018). Conclusions: rejection of contraception is influenced by personal history and religion, with implications for reproductive health

High Reproductive Risk and Contraception

Background: Patients with high reproductive risk have important risk factors for the development of complications, including maternal death. Rejection of a method is influenced by various factors, including: biological, cultural and social factors. Objective: Identify the main sociocultural and demographic factors associated with not choosing a contraceptive method in women at high reproductive risk. Material and methods: it is an observational, cross-sectional, analytical and prospective study with non-probabilistic sampling carried out in pregnant women with high reproductive risk who were offered contraception through a questionnaire. Results: 75 Patients with high reproductive risk (20%) were included, with an average age of 27 years, occupation as a housewife (48%), living in an urban area (66.7%), complete primary schooling (22.67%), Catholic religion (72%), married (57.3%), middle class (72%); alcoholism in 2 patients (2.67%) and 2 other drugs (2.67%); 68% rejected contraception; for personal reasons (76.4%). A significant relationship was found with the Jehovah's Witness religion (p = 0.018). Conclusions: Rejection of Contraception is Influenced by Personal History and Religion, with Implications for Reproductive Health

Review of the Marriage Age Limit Policy in Indonesia Through the Saad al-Dzari'ah Principles

This research examines the latest policy regarding the age limit for marriage in Indonesia, which sets a minimum age of 19 years for both sexes. The main objective is to assess the impact and effectiveness of this policy in the context of social, health and gender equality, through the lens of Saad al- Dzari'ah principles which are oriented towards preventing social damage before it occurs. The methodology used includes a juridical-normative approach with statistical data analysis, case studies, and in-depth interviews with various stakeholders. The results showed a significant reduction in early marriage, an increase in education and economic preparedness, and a reduction in reproductive health risks. This study also identified that the application of Saad al-Dzari'ah principles has been effective in preventing social problems related to early marriage and supporting gender equality. Policy recommendations include increasing the minimum marriage age, broader educational campaigns, integration of religious values in public policy, and regular monitoring and evaluation. This research provides valuable insights for policy makers in formulating marriage regulations that are responsive to ongoing social dynamics, while respecting the juridical, social and religious values of Indonesian society.

Risk factors for infertility and barriers to treatment in Tanzania: a survey and medical records study.

The burden of infertility is serious for women in high-fertility countries. We sought to identify demographic, behavioral/environmental, and reproductive risk factors for various infertility factors (i.e., ovarian, tubal, uterine/cervical, male/other) among women seeking infertility treatment in central Tanzania; to determine the association between pelvic inflammatory disease (PID) and tubal factor infertility (TFI); and to identify barriers to infertility treatment by women's home regional zone. We conducted a cross-sectional survey of women seeking infertility treatment in Dodoma, Tanzania from January-March 2020. We surveyed 168 participants aged 18-49 years and reviewed their medical records to confirm infertility status and potential risk factors. We estimated prevalence ratios for factors associated with infertility using logistic regression. Treatment barriers were compared by women's regional zone to see if barriers varied geographically. The median age of participants was 32 years (range: 18-48). Infertility factors did not vary greatly by patient demographics, behavioral/environmental, or reproductive risk factors. Approximately 31.48% of women had PID diagnoses. Those with PID had 1.94 (95% CI: 1.30, 2.90) times the prevalence of TFI diagnosis as those with other infertility factors, after adjusting for age, pesticide use, alcohol use, age at sexual debut, prior obstetric events, and family history of infertility. Logistical barriers to treatment, such as time and cost, were more frequently reported than emotional, stigma, or other barriers, regardless of regional zone. PID was strongly associated with TFI after adjustment for confounders. Infertility treatment access due to cost remains a challenge in Tanzania.

Reproductive risk factors for breast cancer and association with novel breast density measurements among Hispanic, Black, and White women.

There are differences in the distributions of breast cancer incidence and risk factors by race and ethnicity. Given the strong association between breast density and breast cancer, it is of interest describe racial and ethnic variation in the determinants of breast density. We characterized racial and ethnic variation in reproductive history and several measures of breast density for Hispanic (n = 286), non-Hispanic Black (n = 255), and non-Hispanic White (n = 1694) women imaged at a single hospital. We quantified associations between reproductive factors and percent volumetric density (PVD), dense volume (DV), non-dense volume (NDV), and a novel measure of pixel intensity variation (V) using multivariable-adjusted linear regression, and tested for statistical heterogeneity by race and ethnicity. Reproductive factors most strongly associated with breast density were age at menarche, parity, and oral contraceptive use. Variation by race and ethnicity was most evident for the associations between reproductive factors and NDV (minimum p-heterogeneity:0.008) and V (minimum p-heterogeneity:0.004) and least evident for PVD (minimum p-heterogeneity:0.042) and DV (minimum p-heterogeneity:0.041). Reproductive choices, particularly those related to childbearing and oral contraceptive use, may contribute to racial and ethnic variation in breast density.

Characterization of preconceptional reproductive risk in women of childbearing age

Characterization of preconceptional reproductive risk in women of childbearing age

The Review of the Maslahah Mursalah Related to Early Marriage: Implementation and Orientation

Child marriage is a controversial issue in many countries, including Indonesia, due to its negative impact on girls. Indonesian law regulates the minimum age for marriage, but there are still gaps in its implementation. This issue also relates to social, economic, and health impacts, such as reproductive health risks and limited access to education. This research aims to review the implementation of child marriage policies, policy orientations, and their impact on the understanding and implementation of maslahah mursalah values. This study uses normative legal research methods to examine the issue of child marriage based on the normative aspects present in applicable legislation. The results of the research indicate that the implementation of child marriage policies based on maslahah mursalah in Indonesia should be holistic, considering social, cultural, religious, and legal aspects. This policy should prioritize the common welfare and protection of children's rights, with an emphasis on education, legal protection, reproductive health, and reducing social stigma. The importance of collaboration between the government, NGOs, religious leaders, and the community in designing and implementing this policy is emphasized. Regular evaluations need to be conducted to ensure the effectiveness of the policy in achieving the goals of child protection and public welfare. Additionally, consideration should be given to the cultural and religious diversity in Indonesia while adhering to international commitments supporting the prohibition of child marriage.

Abstract B125: Reproductive factors and thyroid cancer risk: The multiethnic cohort study

Abstract Background : Thyroid cancer is the most common endocrine cancer worldwide, with the incidence in women being three times that of men. Several reproductive and hormonal factors have been proposed as possible contributors to thyroid cancer risk, including age at menarche, parity, age at menopause, oral contraceptive use, surgical menopause, and hormone replacement therapy. Our study aimed to investigate potential reproductive/hormonal factors in a multiethnic population. Methods : A prospective cohort study of women of diverse racial and ethnic groups in the Multiethnic Cohort Study (n=118,344) was used. Included were 373 papillary thyroid cancer cases, linked to SEER cancer incidence and statewide death certificate files in Hawaii and California. Exposures investigated include age at menarche, parity, menopausal status and type, birth control use, and outcomes of first pregnancy. Cox proportional hazards models of papillary thyroid cancer were used to obtain relative risk (RR) and 95% confidence intervals (CI) to examine the associations with reproductive/hormonal factors. Results : We observed a statistically significant increased risk of papillary thyroid cancer for hysterectomy, oophorectomy, surgical menopause, and not having a child by age 20. The adjusted estimates for oophorectomy RR 1.66 (95% CI: 1.31, 2.11) and hysterectomy RR 1.82 (95% CI: 1.42, 2.34). Menopause due to surgery was associated with a 55% increase in risk (RR 1.55, 95% CI: 1.22, 1.97) and nulliparity vs ≤ 20 years of age at first livebirth was related to a 51% increased risk (adjusted RR 1.51, 95% CI: 1.07, 2.15). Adjustment factors included age and race/ethnicity and menopausal status, menopausal type, and oral contraception where appropriate. Former use of estrogen menopausal hormone therapy was associated with a 35% increased risk (adjusted RR: 1.35, 95% CI: 1.02, 1.79). No significant heterogeneity was seen in these associations by race/ethnicity (p het >0.48). Conclusion : The reproductive risk factors for papillary thyroid cancer reported in the literature were largely confirmed in our multiethnic population. Our analysis finds having a hysterectomy or oophorectomy and the use of MHT are associated with an increased risk of papillary thyroid cancer, and having a child at a younger age is associated with a reduction in thyroid cancer risk. Citation Format: Janine V. Abe, Song-Yi Park, Christopher A. Haiman, Loïc Le Marchand, Brenda Y. Hernandez, Lynne R. Wilkens. Reproductive factors and thyroid cancer risk: The multiethnic cohort study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B125.

Assisted reproductive technology-associated risk factors for retained products of conception

ObjectiveTo evaluate assisted reproductive technology-associated risk factors for retained products of conception among live births. DesignRegistry-based retrospective cohort study. SettingNot applicable. Patient(s)Cycle-specific data for a total of 369,608 singleton live births following fresh and frozen–thawed embryo transfers between 2007 and 2017 were obtained from the Japanese assisted reproductive technology registry. Intervention(s)None Main outcome measure(s)Retained products of conception after delivery. Odds ratios and 95% confidence intervals for risk factors associated with retained products of conception during fresh and frozen cycles. Result(s)In total, 132 deliveries (0.04% of eligible assisted reproductive technology registry deliveries) had retained products of conception; 122 (92.4%) of these deliveries occurred after frozen–thawed embryo transfer cycles. Cases with retained products of conception were significantly more likely to have undergone vaginal delivery than cases without retained products of conception (78.0% vs. 61.1%, p < 0.001); they were also more likely to have been complicated with placenta accreta spectrum (24.2% vs. 0.45%, p < 0.001). Among patients undergoing frozen–thawed embryo transfers, factors associated with significantly increased risk of retained products of conception were embryo stage at transfer, use of hormone replacement cycles, and assisted hatching. Use of hormone replacement cycles represented the largest risk factor (adjusted odds ratio, 4.9; 95% confidence interval, 2.0 to 12.4), such that retained products of conception occurred in 0.05% of deliveries following hormone replacement cycles (51 of 97,958 deliveries) but only 0.01% of deliveries following natural cycles (5 of 47,079 deliveries). Subgroup analysis showed that hormone replacement cycles and assisted hatching remained significant risk factors for retained products of conception in cases without polycystic ovary syndrome/anovulation and cases with vaginal delivery, but not cases with cesarean section. Among fresh embryo transfers, an increased number of retrieved oocytes was the only significant risk factor for retained products of conception. Conclusion(s)Our analyses demonstrated that the majority of cases involving retained products of conception were derived from frozen–thawed embryo transfers and identified the use of hormone replacement cycles as the largest risk factor for retained products of conception within this group.

Developing a Reproductive Health Survivorship Care Plan (SCP-R) for Female Adolescent and Young Adult Leukemia and Lymphoma Survivors

In the United States nearly 250,000 female adolescent and young adult survivors of leukemia and lymphoma (AYA survivors) face increased reproductive health risks that vary by cancer treatment exposure. Adverse reproductive health late effects include infertility, spontaneous abortion, preterm birth, and, more rarely, cardiopulmonary risks impacting pregnancy. AYA survivors have significant concerns, misperception of reproductive risks and unmet information needs about their reproductive health. Reproductive concerns range from worry about infertility to pregnancy and offspring health concerns and are associated with depression and poorer quality of life. These concerns can be mitigated through improving health literacy and implementation of screening and management strategies. However, there is a gap in knowledge on how to deliver reproductive risk information and management strategies effectively and efficiently, to a diverse patient population. The overarching objective of this project was to develop a Reproductive Health Survivorship Care Plan (SCP-R) for female AYA survivors of leukemia and lymphoma as a potential strategy to improve reproductive health knowledge and care. Our team of researchers and healthcare providers in AYA oncology, obstetrics and gynecology, and childhood cancer survivorship completed systematic reviews of infertility risks, contraception practices, pregnancy-related complications and offspring health in AYA female cancer survivors. We then categorized the impact of treatment exposures on infertility and pregnancy/offspring health outcomes as “no increase in risk”, “low risk”, “moderate risk” or “high risk” and developed a SCP-R prototype describing an individual's infertility, pregnancy and offspring risks including clinical guidelines on screening and managing infertility, contraception and pregnancy health. In addition to communicating an individual's reproductive health risk, the SCP-R included guides for survivors towards the next steps in improving their reproductive knowledge and care and supported these steps with best evidence-based guidelines. The SCP-R content was reviewed in 4 focus groups by 18 young adult female leukemia and lymphoma survivors, who advised on graphical representation and endorsed relevance, appropriateness, and acceptability. Relevant feedback provided during focus group sessions was incorporated into the current version of the SCP-R. All focus group participants reported a need for reproductive health information and felt that prior resources provided to them regarding reproductive-health related information was not sufficient. Reproductive health care (i.e. fertility, family planning and preconception counseling) deploys appropriate screening and management strategies; evidence-based practices recommended by clinical oncology and reproductive medicine societies. Despite longstanding guidelines supporting reproductive health care in AYA survivors, many fail to receive this type of care. The SCP-R may reduce reproductive risk misperception among AYA survivors and serve as an essential first step towards appropriate reproductive health care, and eventually lead to improved survivor's quality of life. The SCP-R impact on reproductive health knowledge and reproductive health seeking behavior among AYA leukemia and lymphoma survivors warrants further evaluation.

Evaluation of Couples at Risk for Hemoglobin Disorders in Italy: The Results of an 18-Month Retrospective Observational Single-Center Study

Background: Hemoglobinopathies are genetic disorders caused by mutations in the genes encoding globin chains. These conditions are the most common monogenic disorders worldwide, resulting in significant morbidity and mortality among those affected by the most severe forms. Antenatal evaluation for thalassemia and sickle cell disease (SCD) enables couples to know their reproductive risk, thus allowing an informed reproductive choice. However, in certain areas, couples do not often receive the appropriate counseling at the appropriate time. Aim: The aim of this study is to describe the characteristics of couples referred to our tertiary referral center in Milan, Italy, for evaluation of hemoglobinopathy risk and their management. Methods: in our Institution, a diagnostic-therapeutic pathway involving the Hemoglobinopathies unit, the Medical Genetic unit, and the central laboratory has been implemented. Subjects referred to the Institution, and their partner, underwent the following laboratory tests: complete blood count, hemolysis and iron parameters, vitamin pattern, and hemoglobin (Hb) pattern by high-performance liquid chromatography (HPLC). The couples were then evaluated by a hemoglobinopathy expert, and those at risk for Hb disorders were offered a molecular analysis. Couples were then referred to the geneticist to receive the results of the molecular analysis, discuss the genetic risk for the fetus and, in case of high risk, discuss possible reproductive choices (i.e., prenatal diagnosis, pre-implantation diagnosis). We retrospectively collected and analyzed couples' data referred to our center from the 1 st of July 2021 to the 31 st of December 2022. Results: Three hundred and fifty-one couples were evaluated for hemoglobinopathies over 18 months. The median age was 34 years, with a tendency for younger age in female partners; 67% (234/351) of the women were already pregnant at the time of evaluation (median gestational age 18 weeks, range 7-37), while 33% (117/351) were referred for preconception counseling. Individuals from more than 48 different countries were screened, and the most represented countries of origin included: Italy (50%), Nigeria (6%), Bangladesh (4%), and Ivory Coast (4%), underpinning a vastly diverse genomic background. The referral was triggered by either evidence of microcytic anemia (58%) or HPLC anomalies (42%), including Hb variants, HbA2 anomalies, or elevated HbF in at least one partner. 55% of the referrals did not require additional testing. The remaining 45% (158/351) underwent advanced molecular tests to determine the nature of the Hb defect, guided by the results of the first-level panel. Among these, 33 couples (12% of the total) were found to be at risk for transmission of severe clinical forms of β-thalassemia, sickle cell anemia, or compound β-disorder heterozygosity (HbS/β-thal, HbC/HbS). One additional couple (0.4%) was at risk for HbH disease. In addition, 4 couples (1.5%) were found to be at risk for thalassemia intermedia combining a β-thalassemia mutation and α-gene triplication. Of the above, all 34 couples underwent invasive fetal evaluation: 24 women underwent chorionic villous sampling, while 10 received amniocentesis. A diagnosis of thalassemia in the fetus was reported in 6/34 (18%) cases and 3 (9%) of SCD. Interestingly, during the 18 months of observation, among the evaluated adult subjects, we found 4 cases of non-transfusion dependent thalassemia (NTDT) and 1 of HbS/β-thal in otherwise healthy subjects. All 4 cases of NTDT resulted from α-gene triplication paired with a β-thalassemia heterozygous defect. Furthermore, α triplication was found alone in 4 subjects without additional Hb gene defects. Overall, α triplication was detected in 9 out of 154 (5.8%) individuals who underwent HBA gene analysis. Conclusion: The median gestational age at presentation was high, leading to a limited time for couples to receive the appropriate counseling to make an informed reproductive choice. Increasing awareness across all involved specialists remains the mainstay for an effective prevention program to promptly identify at-risk couples and offer counseling at the right time. In addition, the relatively high incidence of α triplication in our population of asymptomatic and hematologically normal subjects and the new diagnosis of 4 NTDT warrants further studies to confirm the prevalence of α triplication in the general population.

Inner cyclic cooling aeration on stored maize in large commercial warehouses in Northeast China

ABSTRACT Controlling grain temperatures is the main approach employed in large commercial warehouses to maintain quality and prevent infestation by insects and fungi. Large commercial warehouses in northeast China have been utilizing inner cyclic cooling aeration (ICCA), a newly developed method for managing summertime temperatures, haphazardly and without tight standards. We utilized a homemade detector to track the temperature, humidity, and CO2 concentrations of maize that was held for four years under ICCA treatment. The monitoring occurred every week, specifically from July 1st to September 30th. In addition, we conducted weekly tests to determine the moisture content (MC) and free fatty acids (FFA) of the stored maize samples. Without the use of ICCA, the average temperature of the stored maize above a depth of 3.5 m ranged from 20°C to 28°C, and the relative humidity (RH) in the headspace was typically higher than 75%. However, when ICCA was applied, the average temperature could be maintained at 22°C, and the RH was below 65% for most of the time. In the first year, the MC of the stored maize at a depth of 1.0 m experienced a loss of approximately 0.5%. However, for one year, there was no significant loss in the MC of the maize stored at the same depth. Furthermore, the FFA in the stored maize at a depth of 1 m increased by 1–5 mg KOH/100 g. The use of ICCA effectively controls the temperature and RH in the stored maize, reducing the risk of insect and fungal reproduction.

Müllerian Anomalies: Presentation, Diagnosis, and Counseling.

Müllerian anomalies represent a complex collection of developmental defects occurring in up to 5% of the general population. They are increasingly more common in individuals with infertility (8.0%) and in those with a history of pregnancy loss (13.3%); they have the highest prevalence in individuals with a history of both (24.5%). A wide spectrum of anomalies can occur based on the stage at which müllerian development ceases in utero, ranging from mild (eg, a partial uterine septum) to severe, with complete absence of the cervix, uterus, and fallopian tubes (eg, müllerian agenesis). The components of the reproductive tract involved and, importantly, whether an obstruction of the tract is involved correlates with the timing of presentation, the constellation of associated symptoms, and the necessity for either medical or surgical management. Individuals, regardless of the severity of the defect, should be counseled on the gynecologic, reproductive, and obstetric risks associated with their specific müllerian anomaly to minimize adverse sequela and outcomes. We will review the clinical presentation, diagnostic evaluation, and clinical counseling of individuals with müllerian anomalies.

Associations Between Sex-Specific Reproductive Factors and Risk of New-Onset Lung Cancer Among Female Patients

Several characteristics distinguish lung cancer in women from that in men, with adenocarcinoma being more prevalent in women and occurring more frequently in nonsmoking women. Uncertainty surrounds the relationship between women-specific reproductive factors and lung cancer risk. Are sex-specific reproductive factors associated with risk of lung cancer in different genetic risk groups and histological types? A Cox proportional hazard model was used to evaluate the association between multiple reproductive factors and the risk of developing lung cancer in a prospective cohort study involving 273,190 women from the UK Biobank. Subgroup analyses stratified by age, smoking status, body mass index, genetic risk, and histological subtype were conducted to further emphasize the modification effects. A total of 1,182 lung cancer in women were recorded over a median follow-up period of 12.0 years in the cohort study. In multivariable-adjusted models, early menarche (age≤11 years: HR 1.22, 95%CI 1.03-1.46), early menopause (age≤46 years: HR 1.49, 95%CI 1.19-1.86), a shorter reproductive span (≤32 years: HR 1.42, 95%CI 1.18-1.71; 33-35 years: HR 1.24, 95%CI 1.00-1.53), and early age at first birth (age≤20 years: HR 1.63, 95%CI 1.33-2.01) were associated with a higher risk of lung cancer. Stratified analysis revealed that several reproductive factors, including early age at menopause, shortened reproductive span, and early age at first birth, had substantially stronger relationship with an elevated risk of lung cancer, particularly of LUAD, in populations with high genetic risk and more detrimental behaviors. Early age at menopause, a shortened reproductive life span, and early age at first birth were associated with higher risks of lung cancer, particularly of LUAD in a subpopulation with higher genetic susceptibility and detrimental behaviors. The evidence provided by this study emphasize the significance of screening for multiple reproductive factors to prevent lung cancer among women.

Abstract 14112: Reproductive Risk Factors and Pulmonary Arterial Hypertension in Women

Introduction: Pulmonary arterial hypertension (PAH) is a devastating disease that affects women more often than men. The female predominance has increased over time; recent U.S. cohorts demonstrate a female:male ratio of nearly 4:1. The role of women-specific risk, such as reproductive exposures, is poorly understood in the pathophysiology of PAH. Hypothesis/Goals: We hypothesize that reproductive exposures influence the development and/or severity of PAH in women. We sought to investigate the role of reproductive factors and contribution of exogenous estrogen exposures to PAH onset and severity. Methods: Using reproductive history/exposure questionnaires from 390 women with PAH, enrolled in both the PAH Biobank and United States Pulmonary Hypertension Scientific Registry, we conducted linear regression analyses to assess the association between individual disease severity variables, as well as REVEAL Lite 2.0 scores, and patient reported reproductive variables as the predictors (Table 1). We adjusted for potential confounders including age, race, BMI, and PAH sub-group (idiopathic, heritable, or associated). Results: We found that younger menopause age, less than or equal to 40 years old, associates with a lower cardiac index (CI) at diagnosis [β -0.57, p 0.02]. The association persisted when controlling for use of hormone replacement therapy (HRT). There was a trend toward lower CI in those with menopause age of 41 to 50 years old, but not statistically significant [p 0.10]. Ever use of HRT was associated with a higher pulmonary vascular resistance [β 1.6, p 0.05] and lower CI [β -0.28, p 0.01] at diagnosis. Conclusion: Premature menopause (age less than 40 years) and ever use of HRT associate with worse hemodynamics at diagnosis in women with PAH, including lower cardiac index. Further investigations into reproductive exposures may offer an opportunity for more comprehensive risk factor screening and modification by physicians treating PAH patients.

Understanding recessive disease risk in multi-ethnic populations with different degrees of consanguinity.

Population medical genetics aims at translating clinically relevant findings from recent studies of large cohorts into healthcare for individuals. Genetic counseling concerning reproductive risks and options is still mainly based on family history, and consanguinity is viewed to increase the risk for recessive diseases regardless of the demographics. However, in an increasingly multi-ethnic society with diverse approaches to partner selection, healthcare professionals should also sharpen their intuition for the influence of different mating schemes in non-equilibrium dynamics. We, therefore, revisited the so-called out-of-Africa model and studied in forward simulations with discrete and not overlapping generations the effect of inbreeding on the average number of recessive lethals in the genome. We were able to reproduce in both frameworks the drop in the incidence of recessive disorders, which is a transient phenomenon during and after the growth phase of a population, and therefore showed their equivalence. With the simulation frameworks, we also provide the means to study and visualize the effect of different kin sizes and mating schemes on these parameters for educational purposes.