Biomedical subjects

B Eskenazi

Publications and source records attributed to B Eskenazi.

At least 19 recordsLinked to original sources

PubMed1997

Epidemiology of endometriosis.

This article summarizes present knowledge about the epidemiology of endometriosis. Surprisingly, little is known about the prevalence or risk factors of endometriosis, given the medical care and employment costs. Knowledge about the epidemiology of endometriosis is hampered by the inability to diagnose this disease in the general population. Based on a single cohort study, it is estimated that there is a 10% prevalence of endometriosis in the general population. Age is the only sociodemographic characteristic for which a consistent positive relationship has been observed. In general, the risk of endometriosis appears to increase for reproductive health factors that may relate to increased exposure to menstruation (i.e., shorter cycle length, longer duration of flow, or reduced parity). The risk appears to decrease for personal habits that may relate to decreased estrogen levels (i.e., smoking, exercise).

Age Factors↗

PubMed1997

Chemotherapy induces transient sex chromosomal and autosomal aneuploidy in human sperm.

Each year more than 20,000 children and young persons of reproductive age are exposed to known mutagens in the form of chemo- and/or radiotherapy for cancer in the States. As more of these treatments are effective there is growing concern that genetic defects are introduced in the germ cells of these young patients. It is well documented for male rodents that treatment with chemo- and radio-therapeutic agents before mating can cause genetic damage in the germ line, and the magnitude of heritable effects depends on the spermatogenic cell stage treated. Similar germinal effects are suspected to occur in humans but remain unproven. Hodgkin's disease (HD) is an example of a malignancy which is typically diagnosed during a patient's reproductive years. In our study we observed eight male HD patients who were treated with NOVP (Novanthrone, Oncovin, Vinblastine, Prednisone) chemotherapy. We evaluated sperm aneuploidy using multi-colour fluorescence in situ hybridization (FISH), and found approximately 5-fold increases in sperm with disomies, diploidies and complex genotypes involving chromosome X, Y and 8. Increases in sex chromosome aneuploidies arose from segregation errors at meiosis I as well as meiosis II. The aneuploidy effects were transient, however, declining to pretreatment levels within approximately 100 days after the end of the therapy. When compared with normal men, some HD patients showed higher proportions of certain sperm aneuploidy types even before their first therapy.

Adult↗

PubMed1996

Change in paternity: a risk factor for preeclampsia in multiparas.

Preeclampsia, a hypertensive disorder of pregnancy, is hypothesized to be a maternal immunologic response to foreign fetal antigen derived from the father's sperm. This response may be reduced by prolonged exposure to father's antigen, such as through a prior pregnancy, which may explain why multiparas are typically at lower risk for preeclampsia than nulliparas. Since multiparas with new partners are presented with a new set of paternal antigen, we hypothesize that they would have the same elevated risk for preeclampsia and gestational hypertension as nulliparas, compared with multiparas with no change in partner. We studied 5,068 nulliparas and 5,800 multiparas, 573 of whom had new partners, selected from the Child Health and Development Studies cohort (Oakland, CA, 1959-1967). Preeclampsia was diagnosed in 3.2% of nulliparas, 3.0% of multiparas with changed paternity, and 1.9% of multiparas with no change. Compared with multiparas with no change, the adjusted odds ratio for preeclampsia among nulliparas was 2.5 [95% confidence interval (CI) = 1.8-3.5]; among multiparas with new partners, the adjusted odds ratio for preeclampsia was 1.4 (95% CI = 0.8-2.4). There was a similar pattern of results for gestational hypertension. The adjusted attributable risk of preeclampsia in multiparas associated with a change in paternity was 29%. Although these findings in part support the immunologic theory of preeclampsia, they also suggest that a subsequent pregnancy with any partner is associated with a reduced risk for preeclampsia.

Adult↗

PubMed1995

Passive and active maternal smoking during pregnancy, as measured by serum cotinine, and postnatal smoke exposure. I. Effects on physical growth at age 5 years.

The authors evaluated the effect of maternal environmental tobacco smoke (ETS) exposure during pregnancy and prenatal maternal smoking on child's height at age 5 years, using serum cotinine as a biomarker of exposure. They also determined the effects of postnatal smoke exposure. Participants included 2,622 women enrolled in the Child Health and Development Studies between 1964 and 1967. Nonsmokers were divided into ETS-exposed (serum cotinine 2-10 ng/ml; n = 77) and not exposed (n = 1,610), and smokers (n = 935) were divided into tertiles based on serum cotinine levels: 0-79, 80-163, and 164-569 ng/ml. Multivariate models adjusting for race, sex, birth order, and maternal height, body mass, education, and age indicated that children of smokers were 0.3, 0.3, and 0.8 cm shorter in the lowest, middle, and highest tertile of serum cotinine, respectively, and children of ETS-exposed women were 0.5 cm taller than those of nonsmokers. Only the children of heavy smokers were significantly shorter than children of nonsmokers; however, this difference disappeared after controlling for birth weight and gestational age. The adjusted heights of children of women who smoked both during and after pregnancy were significantly shorter than those of children of nonsmokers, but this effect also disappeared after controlling for birth weight and gestational age. These results suggest that the effects of smoke exposure on children's height may be explained by the effects of maternal smoking on fetal growth.

Biomarkers↗

PubMed1995

Passive and active maternal smoking during pregnancy, as measured by serum cotinine, and postnatal smoke exposure. II. Effects on neurodevelopment at age 5 years.

The authors sought to determine the neurobehavioral effects of prenatal exposure to maternal active smoking and environmental tobacco smoke (ETS), assessed by maternal serum cotinine level, and of postnatal exposure to smoke based on maternal report. Five-year-old children (n = 2,124) who were participants in the Child Health and Development Studies in Oakland, California, between 1964 and 1967 were evaluated with the use of the Peabody Picture Vocabulary Test (PPVT) and the Raven Coloured Progressive Matrices Test, and also assessed on a behavioral rating scale completed by the mother that included questions on activity level. Children of ETS-exposed women did not differ from children of other nonsmokers on neurobehavioral assessment. Children whose mothers smoked during pregnancy had somewhat higher adjusted Raven (p = 0.10) and PPVT scores (p = 0.06) than children of nonsmokers, although they did not differ in their activity level (p = 0.32). However, children smoke-exposed during childhood did have lower adjusted Raven (p = 0.01) and PPVT scores (p = 0.16), and were rated more active by their mothers (p = 0.04). These differences may be attributed to uncontrolled confounding of sociobehavioral variables. However, the authors cannot rule out the possibility that ETS exposure during childhood may be more hazardous to neurodevelopment than prenatal exposure.

Biomarkers↗

PubMed1995

Association of spontaneous abortion and other reproductive effects with work in the semiconductor industry.

This study tested the hypothesis that fabrication room (fab) work in the silicon-based semiconductor industry is associated with an increased risk of spontaneous abortion (SAB). The study was conducted nationwide at 14 companies representing a spectrum of large to small manufacturers. A small increase in risk of SAB was observed among fab workers compared with nonfabrication room (nonfab) workers in two cohorts, historical (adjusted RR = 1.43, 95% confidence interval [CI] 0.95-2.09) and prospective (adjusted RR = 1.25, 95% CI = 0.63-1.76). Analysis of specific fab exposures in the historical cohort showed a consistent, dose-response association of SAB with photoresist and developer solvents, whose major component was ethylene-based glycol ethers. The consistency of our findings and the toxicological data for these agents suggest that this is a causal association. Independent associations of SAB with self-reported stress and with etching fluorides were observed and require further research. No significant decrease in fertility was observed among men or women working in fabs, but reduced fecundability was suggested for some women fab workers.

Abortion, Spontaneous↗

PubMed1995

Laboratory methods for evaluating early pregnancy loss in an industry-based population.

Laboratory methods were adapted or developed to analyze approximately 70,000 daily urine samples collected during more than 2,500 menstrual cycles from 448 women working in the semiconductor industry. An immunoenzymometric assay (IEMA) for human chorionic gonadotropin (hCG) was employed for screening cycles in order to optimize laboratory resources and to reduce the number of samples requiring analysis by less efficient methods. The presence of hCG in urine was confirmed by the definitive immunoradiometric assay (IRMA). The screening assay eliminated 78% of cycles from further analysis because there was no evidence of conception. Thirty-eight of 448 cycles identified as having significant levels of hCG with the IEMA were confirmed as hCG positive with the IRMA. HCG-positive cycles were further evaluated by examination of daily diary data and by laboratory assays for ovarian and pituitary hormones. As a result of these evaluations, 17 of the 38 cycles identified by the IRMA as positive for hCG were found to be nonconceptive cycles. These results demonstrate the effectiveness of screening assays for hCG, as well as the importance of using multiple urinary biomarkers for the detection of early fetal loss with daily urine samples.

Abortion, Spontaneous↗

PubMed1995

Epidemiologic methods for prospective assessment of menstrual cycle and reproductive characteristics in female semiconductor workers.

Methods were developed to assess potential adverse effects of semiconductor fabrication work in a prospective study of reproductive health. All women aged 18-44 years who worked in seven silicon-wafer fabrication sites in five companies and a frequency-matched sample of women in nonfabrication jobs were included. Among 3,480 selected for screening, 2,639 (75%) completed a self-administered questionnaire to identify women at risk of pregnancy. Among the 739 (28%) eligible women, 481 (65%) completed baseline interviews and 402 (83.6%) completed at least one menstrual cycle of follow-up by providing daily diaries and daily urine samples. Menstrual cycle characteristics were assessed from questionnaires and diaries. Urine samples were assayed for reproductive hormones to identify conceptions. The usual cycle length recalled at baseline was 28 days. The mean cycle length (MCL) recorded in diaries was 29 days, with greater dispersion than at baseline. The median of the MCL from diary data was 28 days for women reporting regular cycles at baseline but 34 days for women reporting irregular cycles at baseline, and the median standard deviation in cycle length per woman was 2.5 days and 7.5 days, respectively. The prospective method, while expensive and labor intensive, showed good compliance. Nevertheless, recall also provided reasonably accurate estimates and distinguished women with regular and irregular cycles.

Adolescent↗

PubMed1995

Prospectively assessed menstrual cycle characteristics in female wafer-fabrication and nonfabrication semiconductor employees.

Women aged 18-44 years in silicon-wafer fabrication-room (fab) jobs and frequency-matched women in nonfab jobs were screened for a prospective study of reproductive health (n = 2,639). Among the 739 (28%) eligible women, 481 (65%) completed a baseline interview; 402 completed at least one menstrual cycle of follow-up with daily diaries and urinary assays to exclude conceptive cycles. Adjusted mean cycle lengths (MCL) did not differ between fab and nonfab women (p = 0.97). Women working in thin film and ion implantation (TFII) had the highest adjusted MCL (34.8 +/- 1.7 days) compared with nonfab workers (32.5 +/- 1.4 days, p = 0.07). Among women working exclusively in one group, TFII women had significantly higher MCL (36.1 +/- 2.04 days) than nonfab women (32.0 +/- 1.38 days, p = 0.017). TFII women were also more likely to have all cycles > 35 days (adjusted relative risk [RR] = 2.45; 95% CI = 0.85-6.06). Variability was assessed by logarithmic transformation of the mean standard deviation (MLSD) in cycle length per woman and adjusted for age and ethnicity (4.5 days for fab vs. 4.0 days for nonfab, p = 0.16). Women working exclusively in TFII or photolithography (PHOTO) had significantly higher adjusted MLSD in cycle length (6.68 +/- 1.28 and 5.72 +/- 1.24 days, respectively) than women in nonfab (4.1 +/- 1.16 days, p = 0.013 and 0.019, respectively). Fab and nonfab women did not differ significantly in mean days of bleeding or risk of having cycles > 35 or < 24 days. However, elevated risks of having cycles < 24 days were seen in supervisor engineers (adjusted RR = 2.46, 95% CI = 1.19-3.63) and PHOTO women (adjusted RR = 1.83, 95% CI = 0.94-2.88).

Adolescent↗

PubMed1995

Prospective assessment of fecundability of female semiconductor workers.

To investigate a possible effect of reduced fecundability (probability of conception per menstrual cycle) among women who fabricate silicon wafers, 152 fabrication-room (fab) and 251 nonfab workers were followed for an average of five menstrual cycles. Daily urine samples were analyzed to confirm clinical spontaneous abortions (SABs) and early fetal losses (EFLs). Adjusted fecundability odds ratios (FRs) for fab workers ranged from 0.59 to 0.72 (p = 0.09-0.28 vs. nonfab). For clinical pregnancies only, the adjusted FR ranged from 0.43-0.50 (p = 0.04-0.09 vs. nonfab). This lower fecundability was most pronounced among dopants and thin-film workers [adjusted FR = 0.61, 95% confidence interval (CI) = 0.27-1.40 for all pregnancies; adjusted FR = 0.22, 95% CI = 0.05-0.96 for clinical pregnancies] and in workers exposed to ethylene-based glycol ethers (adjusted FR = 0.37, 95% CI = 0.11-1.19).

Abortion, Spontaneous↗

PubMed1995

Prospective monitoring of early fetal loss and clinical spontaneous abortion among female semiconductor workers.

Women who work in silicon wafer fabrication rooms (fabs) have been reported to have an increased risk of spontaneous abortion (SAB). Although previous studies have included only clinically recognized SABs, more than two-thirds of SABs may be clinically unrecognized. To determine whether fab work is associated with SAB, we recruited 152 fab and 251 nonfab workers, who collected urine samples for a 6-month period. Samples were analyzed by immunoradiometric assay for the presence of human chorionic gonadotropin to detect early fetal losses. Approximately 63% of fab and 46% of nonfab pregnancies ended in SAB [adjusted relative risk (RR) = 1.25; 95% confidence interval (CI) = 0.63-1.76]. Similar RR were seen for women who worked in dopant and thin-film processes (adjusted RR = 1.30; 95% CI = 0.51-1.96) or in masking (adjusted RR = 1.30; 95% CI = 0.59-1.84). The four pregnancies among women who worked with ethylene-based glycol ethers ended in SAB.

Abortion, Spontaneous↗

PubMed1995

Effect of cigarette smoking and coffee drinking on time to conception.

To test the hypothesis that coffee consumption and cigarette smoking are associated with time to conception, we analyzed data collected from 1,341 primigravidas participating in the Child Health and Development Studies in the San Francisco Bay Area between 1959 and 1966. Women were interviewed in person about their reproductive and medical history, habits (smoking, coffee and alcohol consumption), and sociodemographic characteristics. Logistic regression models showed that after adjusting for covariates, women who smoked cigarettes had about one-half the fertility [odds ratio (OR) = 0.5-0.6] of nonsmoker-noncoffee drinkers for times to conception of 6 and 12 months, regardless of whether they drank coffee. On the other hand, coffee consumers who did not smoke did not have decreased fertility compared with nondrinkers who did not smoke (adjusted OR = 1.0-1.2). Coffee drinking did not increase the risk of delayed conception among smokers over the risk posed by the smoking exposure by itself (adjusted OR = 0.6-0.8). We observed an effect of smoking even at low doses (1-9 cigarettes per day). The present study adds to the evidence of an association between cigarette smoking and reduced fertility.

Adult↗

PubMed1995

Workshop on perinatal exposure to dioxin-like compounds. II. Reproductive effects.

This summary report focuses on current studies on reproductive effects reported at the workshop on Perinatal Exposure to Dioxin-like Compounds and supporting data noted in the discussion. Recent laboratory studies have suggested that altered development (e.g., low birth weight, spontaneous abortion, congenital malformation) and reproductive health (e.g., fertility, sex organ development, reproductive behavior) may be among the most sensitive end points when examining the effects of dioxinlike compounds. Thus, future research should target the reproductive health of both males and females exposed postnatally and prenatally. Studies in humans are needed and are on-going. In animal models, postnatal exposure to dioxin or dioxinlike compounds has been associated with abnormal spermatogenesis and abnormal testicular morphology and size in males and with reduced fertility and endometriosis in females. In utero exposure may also produce profound reproductive consequences in both males and females including delays in sexual maturation, abnormalities in development of sexual organs, and abnormal sexual behavior. The mechanism by which dioxin-like compounds cause reproductive effects is not well delineated.

Animals↗

PubMed1995

Passive and active maternal smoking as measured by serum cotinine: the effect on birthweight.

To determine how maternal exposure to environmental tobacco smoke affects birthweight, maternal sera obtained from 3529 pregnant women around 27 weeks gestation were analyzed for cotinine, a metabolite of nicotine. Based on cotinine levels, nonsmokers were divided into those exposed to environmental tobacco smoke (2-10 ng/mL) and those unexposed (< 2 ng/mL), and smokers were divided into tertiles. Compared with unexposed nonsmokers' infants, infants of exposed nonsmokers averaged 45 g less (P = .28) after adjustment for confounders, and smokers' infants averaged 78, 191, and 233 g less for the first, second, and third cotinine tertiles, respectively. Birthweight decreased 1 g for every nanogram per milliliter of cotinine increase (P < .001).

Analysis of Variance↗

PubMed1995

Exercise during pregnancy and pregnancy outcome.

To investigate the effects of participation in aerobic exercise on pregnancy outcome, 388 women (mean age = 31.7, range = 18-42) were followed from a mean 16.5-wk gestation through delivery. Frequency, duration, and mode of aerobic exercise prior to conception and during the first trimester were determined by in-person interviews. Activity patterns during the second and third trimesters were assessed by telephone interviews. For each time period, women were categorized into one of the following exercise groups: Level I = aerobic exercise, excluding vigorous walking, at least three times a week for at least 20 min a time; Level II = aerobic exercise at least three times a week and 20 min at a time, if and only if vigorous walking is included; Level III = aerobic exercise less than three times a week, 20 min a time; and Level IV = aerobic exercise less than once a week. Mean birthweight was statistically unrelated to level of exercise preconceptionally or in any trimester. Gestational age, weight gain, and other pregnancy outcomes were also unassociated with exercise level. However, pregnancy symptoms were inversely associated with level of exercise; women who exercised more earlier in pregnancy reported fewer discomforts later in pregnancy (P = 0.01). These data suggest that participation in aerobic exercise during pregnancy at a level great enough to produce or maintain a training effect does not adversely affect birthweight or other maternal and infant outcomes but may be associated temporally with fewer perceived pregnancy-associated discomforts.

Adult↗

PubMed1994

Physical exertion as a risk factor for spontaneous abortion.

This study examined the association of physical exertion and spontaneous abortion in a case-control study of 607 women whose pregnancies ended in spontaneous abortion and 1,287 women who delivered livebirths in Santa Clara County, CA, in 1986 and 1987. We interviewed women about the number of hours they spent doing heavy housework and caring for young children. We also interviewed women employed during their pregnancies (71% in each group) about their work schedule; the number of hours they worked, stood, commuted, and stooped or bent; and the number of times per day they lifted weights of > 15 pounds. Standing > 8 hours per day at work was the only variable associated with increased risk [adjusted odds ratio (OR) = 1.6; 95% confidence limits (CL) = 1.1, 2.3]. This association was present only for women with a history of spontaneous abortion (adjusted OR = 2.8; 95% CL = 1.4, 5.9). Among women with this history, the OR for a second trimester abortion was 4.9 (95% CL = 1.9, 12.2). Cleaning house for > 7 hours per week or caring for young children for > 50 hours per week was associated with decreased risk (adjusted OR = 0.6, 95% CL = 0.5, 0.9; adjusted OR = 0.8, 95% CL = 0.6, 1.0, respectively). Again, these associations were specific to women with a history of spontaneous abortion (adjusted OR = 0.4, 95% CL = 0.2, 0.7; adjusted OR = 0.5, 95% CL = 0.3, 0.8). These results indicate that the specific type of physical exertion, the amount of exertion, and the context of the exertion may be important.

Abortion, Spontaneous↗

PubMed1994

Possible risk of endometriosis for Seveso, Italy, residents: an assessment of exposure to dioxin.

A recent study by Rier et al. showed that rhesus monkeys exposed daily for 4 years to 5 or 25 ppt of dioxin in food develop endometriosis, with incidence and severity related to dose. We aimed to determine whether the total time-integrated dioxin exposure of a human population could be comparable to that of Rier's monkeys. We selected a sample of residents of Seveso, Italy, who were acutely exposed to high levels of dioxin following an accident in 1976. We conducted a toxicokinetic analysis which takes into account species and exposure differences in dose and timing between humans and monkeys. The area under the time-concentration curve for dioxin in fat, which corresponds to cumulative exposure over time, ranges for some of the most heavily exposed Seveso residents from approximately 1.7 x 10(6) ppt-days to 1.1 x 10(8) ppt-days. These values exceed in all cases the values for the monkeys exposed to 25 ppt or 5 ppt. Given their exposure, the Seveso population should be an ideal epidemiologic cohort to rule out or confirm whether exposure to dioxin leads to an increased risk of endometriosis in humans.

Accidents↗

PubMed1994

Black-white differences in serum cotinine levels among pregnant women and subsequent effects on infant birthweight.

OBJECTIVES: Higher levels of serum cotinine (a metabolite of nicotine) have been found in Black smokers than in White smokers even after self-reported cigarette dose was controlled. It is unknown whether higher cotinine levels in Black pregnant smokers may increase the risk of delivering an infant of reduced birthweight. METHODS: We analyzed serum cotinine levels of 374 Black and 829 White women who smoked during pregnancy and who delivered between April 1964 and April 1967. Racial differences in the relationship between cotinine and birthweight were examined. RESULTS: Cotinine levels were 27.4 ng/mL higher in Black smokers after cigarette dose and confounding variables were controlled. Blacks had higher cotinine levels than Whites at each dose. No significant racial differences in the rate of decrease in birthweight per nanogram of cotinine per milliliter were found. CONCLUSIONS: Our results confirm previous research showing higher cotinine levels at each smoking dose in Black smokers than in White smokers. Because there was no difference in the rate of decrease in birthweight due to cotinine, our results suggest that cigarette smoking among Blacks may have a greater effect on birthweight than it does among Whites.

Black or African American↗