- Email: [email protected]
Traditional gestational age assessment
Early Menopause and Heart Attack Risk Rosenberg L, Hennekens C, Rosner B, et al.: Early menopause and the risk of myocardial infarction. Am J Obstet Gynecol 139:47, 1981. This study further investigates the relationship between early menopause and an increased risk of nonfatal myocardial infarction (MI). Studies were done on 279 women under age 56 who were hospitalized for MI and 5580 control subjects selected from among 121,964 registered nurses who responded to a mail questionnaire. Of the 279 Ml cases, 123 (44%) were postmenopausal at the time of the MI compared with 1859 (33%) of the 5580 age-matched control subjects. Those women who were postmenopausal due to bilateral oophorectomy had an estimated relative risk of MI 2.9 times that of women postmenopausal due to natural causes. Hysterectomy with retention of at least one ovary was associated with only a small increase in risk of MI, and there was no association of natural menopause with risk of MI. The relative risk estimates were found to increase with decreasing age at bilateral oophorectomy, with women under 35 showing a relative risk of 7.2 when compared to premenopausal women. This increase in risk of MI could not be explained by cigarette smoking, predisposing conditions, female hormone supplements, oral contraceptives, place of residence, or calendar year. Oral Contraceptives, Sexual Activity, and Cervical Carcinoma Swan S, Brown W: Oral contraceptive use, sexual activity, and cervical carcinoma. Am J Obstet Gynecol 139:52. 1981. This study was designed to investigate the interrelationships between these two Journal of Nurse-Midwifery Co@ght
@ 1981 by the American
??
factors widely believed to have a role in the development of cervical epithelial dysplasia and carcinoma. The authors felt that factors of sexual activity had not been adequately researched in the many studies linking oral contraceptive use to the development of cervical carcinoma. For the 70 cases of cervical carcinoma (CaCx) 216 matched controls were selected and compared. Through stepwise discriminant analysis two sex-related variables were found which separated the cases from controls almost as well as using all 12 noncontraceptive variables. These were the total number of sexual partners and the mean age at onset of regular intercourse. The mean number of sexual partners for all case subjects was about twice that for control subjects, and the mean age at onset of regular intercourse was about 1 r/2 years earlier for cases as for controls. Other sex-related variables such as number and type of vaginal infections or number of therapeutic abortions were not found to be helpful in discriminating cases from controls. In looking at the duration of oral contraceptive use, the authors found the highest risk among those women who had used oral contraceptives from 4 to 6 years, and this was consistent across all levels of sexuality. The authors conclude that the effects of oral contraceptive use and sexual behavior appear to interact, so that the most sexually active women who are also oral contraceptive users are at highest risk of developing cervical carcinoma. The increased risk of CaCx with prolonged oral contraceptive use up to 6 years in this study does icance.
not reach
signif-
Traditional Gestational Age Assessment Andersen H, Johnson T, Barclay M, Flora J: Gestational age assessment. I. Analysis of individual clinical ob-
Vol. 26. No. 5, September/October
College
statistical
of Nurse-Midwives
servations. Am J Obstet 139:173, 1981.
Gynecol
The purpose of this study was to evaluate the traditional methods used for estimating gestational age and to compare their relative accuracies. Criteria chosen included: last menstrual period (LMP),
quickening, date of first audible fetal heart tones, date of uterus at the umbilicus, and fundal height in centimeters. A group of 418 patients who delivered term babies weighing more than 3000 g after spontaneous labor were chosen for analysis. The number of days from each of the five criteria events to the date of delivery was determined and compared. When the last menstrual period was known this was the most accurate estimator of gestational age, significantly more precise than fetal heart tones, fundal height, and quickening. The uterus at the umbilicus was statistically more accurate than quickening. And quickening, fundal height, and fetal heart tones showed no significant differences in precision. Thus the order of decreasing precision was: (1) LMP; (2) uterus at the umbilicus; (3) fetal heart tones, fundal height, and quickening. The data presented here suggest that the EDC can be predicted with 90% certainty only within -~3 weeks by the single most accurate estimator.
Maternal Acetonuria Not Found Harmful Naeye R, Chez R: Effects of maternal acetonuria and low pregnancy weight gain on children’s psychomotor development. Am J Obstet Gynecol
139:189,
1981.
Current obstetric practice seeks to avoid weight loss and maternal acetonuria during pregnancy due to the belief that ketone bodies transferred through the placenta to the fetal brain could cause
1981
45 0091.2182/81/050045+3$02.50
@ 1981 by the American
??
factors widely believed to have a role in the development of cervical epithelial dysplasia and carcinoma. The authors felt that factors of sexual activity had not been adequately researched in the many studies linking oral contraceptive use to the development of cervical carcinoma. For the 70 cases of cervical carcinoma (CaCx) 216 matched controls were selected and compared. Through stepwise discriminant analysis two sex-related variables were found which separated the cases from controls almost as well as using all 12 noncontraceptive variables. These were the total number of sexual partners and the mean age at onset of regular intercourse. The mean number of sexual partners for all case subjects was about twice that for control subjects, and the mean age at onset of regular intercourse was about 1 r/2 years earlier for cases as for controls. Other sex-related variables such as number and type of vaginal infections or number of therapeutic abortions were not found to be helpful in discriminating cases from controls. In looking at the duration of oral contraceptive use, the authors found the highest risk among those women who had used oral contraceptives from 4 to 6 years, and this was consistent across all levels of sexuality. The authors conclude that the effects of oral contraceptive use and sexual behavior appear to interact, so that the most sexually active women who are also oral contraceptive users are at highest risk of developing cervical carcinoma. The increased risk of CaCx with prolonged oral contraceptive use up to 6 years in this study does icance.
not reach
signif-
Traditional Gestational Age Assessment Andersen H, Johnson T, Barclay M, Flora J: Gestational age assessment. I. Analysis of individual clinical ob-
Vol. 26. No. 5, September/October
College
statistical
of Nurse-Midwives
servations. Am J Obstet 139:173, 1981.
Gynecol
The purpose of this study was to evaluate the traditional methods used for estimating gestational age and to compare their relative accuracies. Criteria chosen included: last menstrual period (LMP),
quickening, date of first audible fetal heart tones, date of uterus at the umbilicus, and fundal height in centimeters. A group of 418 patients who delivered term babies weighing more than 3000 g after spontaneous labor were chosen for analysis. The number of days from each of the five criteria events to the date of delivery was determined and compared. When the last menstrual period was known this was the most accurate estimator of gestational age, significantly more precise than fetal heart tones, fundal height, and quickening. The uterus at the umbilicus was statistically more accurate than quickening. And quickening, fundal height, and fetal heart tones showed no significant differences in precision. Thus the order of decreasing precision was: (1) LMP; (2) uterus at the umbilicus; (3) fetal heart tones, fundal height, and quickening. The data presented here suggest that the EDC can be predicted with 90% certainty only within -~3 weeks by the single most accurate estimator.
Maternal Acetonuria Not Found Harmful Naeye R, Chez R: Effects of maternal acetonuria and low pregnancy weight gain on children’s psychomotor development. Am J Obstet Gynecol
139:189,
1981.
Current obstetric practice seeks to avoid weight loss and maternal acetonuria during pregnancy due to the belief that ketone bodies transferred through the placenta to the fetal brain could cause
1981
45 0091.2182/81/050045+3$02.50