PubMed Health⌕ Search

Biomedical subjects

F Parazzini

Publications and source records attributed to F Parazzini.

At least 235 records · Page 13Linked to original sources

Risk factors for varicose disease before and during pregnancy.

Risk factors for varicose disease before and during pregnancy have been analyzed by use of data from a survey on venous disease in pregnancy conducted in 611 women (mean age thirty years, range fifteen to forty-seven) who consecutively delivered at the Obstetric-Gynecologic Clinic "L. Mangiagalli" of Milan between January and April, 1989. In total, 137 women (22%) reported varicose disease before the index pregnancy. The relative risk (RR) of varicose disease before the index pregnancy increased with age, being, as compared with women aged twenty-nine years or less, 1.6 in those aged thirty to thirty-four and 4.1 in those aged thirty-five years or more (chi 2(1) trend 25.28, p < 0.001). Compared with nulliparae, women reporting a full-term pregnancy before the index pregnancy had an RR of venous disease of 1.2, and the risk increased to 3.8 in women reporting two or more births (chi 2(1) trend 25.28, p < 0.001). A family history of varicose disease was associated with an RR of venous disease of 6.2 (95% confidence interval, CI, from 4.1 to 9.6). No relationship emerged between varicose disease and overweight. Of the 474 women who did not report venous disease before the index pregnancy, 132 (28%) developed venous disease during the index pregnancy. The risk of developing venous disease in pregnancy increased with age, being, as compared with women aged twenty-four years or less, 4.0 in those aged thirty-five years or more, and the trend in risk was statistically significant (chi 2(1) trend 16.25, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Risk factors for multiple births.

STUDY OBJECTIVE: To analyze risk factors for multiple births. DESIGN: A case-control study. Cases were 103 women (median age 31 years, range 20-44) who delivered multiple births not related with treatment for infertility at the 'Clinica Luigi Mangiagalli' of Milan. A total of 27 women delivered monozygotic twins and 76 dizygotic ones. Controls were 308 women (median age 30, range 17-45) admitted for normal delivery on selected days to the same clinic where cases had been identified. RESULTS: Cases tended to be less educated than controls and the relative risk of multiple pregnancy, compared with women reporting seven years of schooling or less, was 0.4 in those reporting 7-11 and 12 or more years of education. When the analysis was done separately for dizygotic and monozygotic multiple pregnancies, this relationship was restricted to dizygotic multiple pregnancies (chi 2 (1) trend for dizygotic pregnancies = 3.82, p = 0.05). A family history of multiple pregnancies was reported in 36 women (48%) with dizygotic multiple pregnancy and 13 (52%) monozygotic ones and 88 (30%) controls. The corresponding relative risks (RR) were 2.2 and 2.5 respectively for dizygotic and monozygotic pregnancies. Compared with nulliparae, the estimated RR of dizygotic multiple pregnancies was 0.5 in women reporting two or more births, but the trend in risk with number of births was not statistically significant. No relationship emerged with spontaneous or induced abortions, body mass index, oral contraceptive or IUD use, age at menarche and risk of multiple pregnancies. CONCLUSIONS: This study confirms the role of familiarity in the risk of multiple pregnancies and suggests some different epidemiological characteristics in dizygotic and monozygotic multiple pregnancies.

Adolescent↗

Risk factors for respiratory distress syndrome in the newborn. A multicenter Italian survey. Study Group for Lung Maturity of the Italian Society of Perinatal Medicine.

Risk factors for respiratory distress syndrome (RDS) in the newborn have been evaluated using data from a large survey conducted between 1980 and 1989 in selected periods in eleven perinatal units placed in five Italian regions. A total of 1624 liveborn infants consecutively delivered at the collaborating centers, at delivery 26-37 weeks gestational age and without clinically evident congenital anomalies were included in the survey. All the newborns were followed up to the 28th day of life. A total of 131 newborns (7.8%) developed RDS. Overall 1st-7th and 1st-28th day of life infant mortality rates were 54.8 and 61.6/1,000 livebirths; the corresponding rates in babies who developed RDS were 419.8 and 465.6/1,000 livebirths. The frequency of RDS was higher in males than in females and the corresponding relative risk, RR, was 0.7, with 95% confidence interval, CI, ranging from 0.5 to 0.9. The risk of RDS markedly increased with decreasing birth weight: compared to babies weighing more than 2500 g at birth the RR estimates were respectively 1.4, 4.5, 8.8 and 39.3 in those weighing > 2000-2500 g, > 1500-2000 g, > 1000-1500 g and 1000 g or less. Likewise, compared to babies born between the 35th and the 37th week of gestation, the RR of RDS was 3.3 and 21.5 in those born between the 31st-34th or before the 31st week of gestation. Multiple pregnancy, gestational or chronic diabetes, pregnancy-induced or chronic hypertension and premature rupture of the membranes were not related to the risk of RDS.(ABSTRACT TRUNCATED AT 250 WORDS)

Apgar Score↗

Determinants of hysterectomy and oophorectomy in northern Italy.

We analysed determinants of hysterectomy and oophorectomy using data from hospital control subjects, interviewed in a large case-control study on risk factors for breast cancer, conducted since 1983 in the Greater Milan area, Italy. Out of the 2916 women interviewed 355 (12.2%) were hysterectomized. Mean age at hysterectomy was 52. The cumulative probability of hysterectomy was similar in women born during the periods from 1900 to 1909 and 1910 to 1919. It rose steadily in each subsequent cohort for all ages till the cohort born between 1930 and 1939, then decreased in the cohort born between 1940 and 1949. The cumulative probability of hysterectomy by 60 years of age was 12.8% in women born between 1900 and 1909, and of 9.8%, 16.7% and 22.0% respectively in subsequent cohorts. Concerning determinants of hysterectomy, we found no relation with education and parity. Among the 355 hysterectomized women, 178 (50.1%) underwent unilateral (40 women) or bilateral (138 women) oophorectomy. The probability of oophorectomy was higher in more educated women. Compared with women who had had hysterectomy before the age of 45, those aged between 45 and 54 reported more frequently oophorectomy (odds ratio (OR): 1.5, 95% confidence interval (CI) from 0.9 to 2.3), but the OR was only 0.8 in those aged 55 or more (95% CI from 0.3 to 2.2). We found no relation between menopausal status or cohort of birth and oophorectomy.

Adult↗

Repeated gestational trophoblastic disease after natural and heterologous assisted conception. A case report.

We report the case of a woman with a familial history of gestational trophoblastic disease who developed repeated partial and complete moles after fertilization by her husband and heterologous assisted conception. This case has interesting etiologic implications, but it is difficult to make any extrapolation from this very peculiar case in terms of definition/quantification of maternal and paternal components in the development of gestational trophoblastic disease.

Adult↗

Hysterectomy, oophorectomy, and subsequent ovarian cancer risk.

OBJECTIVE: To analyze the relation between hysterectomy with or without oophorectomy and the risk of subsequent ovarian cancer. METHODS: We have conducted a case-control study since 1983 in a network of general and university hospitals in the greater Milan area. The cases were 953 women aged less than 75 years with histologically confirmed epithelial ovarian cancer. Women younger than 75 years residing in the same geographic area and admitted for acute conditions to the same network of hospitals where the cases had been identified were eligible as controls. Potential controls were excluded if they had been admitted for gynecologic, hormonal, or neoplastic diseases or had previously undergone bilateral oophorectomy. A total of 2758 controls were interviewed. RESULTS: Fifty-two cases (5.5%) and 215 controls (7.8%) reported a history of hysterectomy, including eight cases and 38 controls who also reported unilateral oophorectomy. In comparison with women with intact uterus and ovaries, the age-adjusted relative risk (RR) was 0.7 in both women who reported hysterectomy alone (95% confidence interval [CI] 0.5-0.9) and in those reporting hysterectomy plus unilateral oophorectomy, though the latter finding was not statistically significant (95% CI 0.3-1.4). The risk of ovarian cancer was inversely related with time from hysterectomy. Compared with women reporting no pelvic surgery, the RR was 0.9 (95% CI 0.4-1.7), 0.7 (0.3-1.6), 0.7 (0.3-1.4), and 0.5 (0.3-0.8), respectively, in women reporting hysterectomy within 4 years or less and 5-9, 10-14, and 15 years or more before interview. CONCLUSION: Hysterectomy approximately halves the risk of ovarian cancer, possibly because of altered ovarian blood flow or the opportunity that hysterectomy provides for examining the ovaries.

Adult↗

Reproductive prognosis after hysteroscopic metroplasty in 102 women: life-table analysis.

OBJECTIVE: To evaluate reproductive prognosis after hysteroscopic metroplasty. DESIGN: The cumulative proportions of women who became pregnant and gave birth, subdivided according to previous obstetric history, were calculated by the product limit method and compared using the log rank test. SETTING: Outpatient infertility clinic of Milan University. PATIENTS: One hundred two consecutive patients with complete (n = 23) or partial septate uterus (n = 79) referred because of infertility or repeated abortion. INTERVENTION: Hysteroscopic metroplasty performed by microscissors (n = 80), argon laser (n = 10), or electroresectoscope (n = 12). MAIN OUTCOME MEASURES: Postoperative cumulative pregnancy and birth rates. RESULTS: At 36 months the cumulative pregnancy and birth rates were 89% and 75%, respectively, in the septate uterus group and 80% and 67% in the subseptate uterus group. CONCLUSIONS: Reproductive prognosis after hysteroscopic metroplasty was favorable and not influenced by the malformation subclass.

Adolescent↗

Determinants of estrogen replacement therapy use in northern Italy.

Socio-demographic characteristics, general lifestyle habits and menstrual and reproductive history were compared in 83 women aged 45 years or more who had at some time used estrogen replacement therapy (ERT) and 1759 never users interviewed as control subjects in the framework of a large case-control survey on risk factors for gynecological neoplasms conducted in Northern Italy. ERT use was strongly related to social class and level of education. The odds ratio of "ever" use was 3.0 (95% confidence interval, CI, 1.8-5.1) for women with 12 or more years of education, compared with those with less than 7 years. No relationship emerged between marital status and ERT use, but parous women tended to be less frequently ever users than nulliparous, and ERT use decreased with increasing number of births (chi 2 1 trend = 10.51, p. = 0.001). Post-menopausal women reported more frequent ERT use than peri-menopausal ones, and among post-menopausal subjects the use was more frequent in those reporting earlier age at menopausal (chi 2 1 trend = 5.33, p = 0.02). There was no association between smoking habits and ERT use, but Quetelet's index was inversely related to the use of ERT.

Aged↗

Number of sexual partners and age at first intercourse in subsequent generations of Italian males and females.

Trends in the number of sexual partners and in age at first intercourse were analyzed using data on 706 men and 1206 women drawn from the hospital control groups of two case-control studies conducted since 1981 in Northern Italy. The overall lifelong mean number of sexual partners was 7.5 +/- 12.8 for men and 1.4 +/- 1.8 for females. The mean number of sexual partners was 6.0 for men born between 1910 and 1919, and 7.3, 9.0, 6.3 and 5.5 for subsequent 10 year birth cohorts. Mean age at first intercourse was 20.7 for the cohort born in 1910-19 and was fairly stable in men born after 1919, ranging from 18.4 to 18.8. Women had a substantially lower number of sexual partners than men in each subsequent birth cohort. However, the mean number of sexual partners increased from 1.1 in the 1910-19 cohort to 1.2, 1.2, 1.4 and 2.3 in subsequent birth cohorts, and the mean age at first intercourse decreased from 23.6 years to 23.1, 22.7, 21.3 and 19.7. These figures should be considered with caution, on account of the non-representativeness of the sample and of a possible under-reporting of number of partners by women. Still, Italian women, although not necessarily men, report substantially fewer sexual partners than northern European on American ones.

Adolescent↗

Menstrual and reproductive factors and breast cancer in women with family history of the disease.

The relationship between socio-economic indicators, body mass, reproductive and menstrual factors and risk of "familial" breast cancer has been analyzed using data from a large case-control study of breast cancer conducted in Italy. A total of 3,037 breast-cancer patients aged 75 years or less admitted to a network of hospitals in the Greater Milan area were interviewed. Controls were 2,569 women aged 75 or less, admitted for acute conditions to the same network of hospitals where cases had been identified. Women were not included as controls if they had been admitted for gynecological, hormonal or neoplastic diseases. A total of 331 cases and 121 controls reported a family history of breast cancer in their first-degree relatives, with a family history tended to be more educated and of higher social class than controls with family history, but these differences were not statistically significant. No relationship emerged with marital status and body-mass index. The estimated multivariate relative risks were, compared with nulliparous women, respectively 0.9, 1.2 and 1.2 for women reporting 1, 2 and 3 or more births. The risk of breast cancer was also greater in women reporting one or more spontaneous abortions: compared with those who did not, the estimated relative risk was 1.9 (95% confidence interval 0.8 to 3.7). Relative to women reporting their first birth below age 25, the estimated relative risks were 1.3 and 0.9 in those reporting it at age 25 to 29 and 30 or more respectively. Likewise, no consistent relationship emerged with lifelong menstrual pattern and menopausal status. These results suggest that menstrual and reproductive factors do not play an important role in the risk of breast cancer in women with a history of the disease in first-degree relatives.

Abortion, Spontaneous↗

Risk factors for cervical intraepithelial neoplasia.

To evaluate risk factors for cervical intraepithelial neoplasia (CIN), data were collected in a case-control study based on 366 patients (58 with CIN class 1, 70 with CIN class 2, and 238 with CIN class 3) and 323 control subjects with normal cervical smears interviewed on selected days at the same screening clinics where cases had been identified. No relationship emerged between indicators of socioeconomic status (education and social class) and risk of mild/moderate (considered together) and severe dysplasia. A total of 55 (43%) patients with CIN class 1 or 2, 107 (45%) patients with CIN class 3, and 94 (29%) controls were current smokers. The corresponding relative risk (RR) estimates for current versus never smokers were 1.9 (95% confidence interval [CI] 1.2 to 3.0) for patients with CIN class 1 or 2 and 2.5 (95% CI 1.7 to 3.6) for patients with CIN class 3, and the risk increased with the number of cigarettes smoked per day. No relationship was observed between oral contraceptive use, parity, spontaneous or induced abortions and the risk of CIN, but patients tended to report earlier age at first birth than control subjects. Compared with women reporting their first birth before the age of 20 years, the risk estimates were 0.5 and 0.4, respectively, for patients with CIN 1 or 2 and patients with CIN 3 in women reporting first birth at 20 to 24 years of age. The risk estimates were 0.5 and 0.6 for those reporting their first birth at age 25 or later, but the trends in risk were not statistically significant. The number of sexual partners was directly associated with the risk for both histopathologic subgroups. Compared with women reporting no intercourse or their first intercourse after 22 years of age, women with first intercourse before the age 18 had a RR estimate of CIN class 1 or 2 of 2.3 and of CIN class 3 of 2.4, with the trends in risk being statistically significant. This study confirms considerable similarities in the epidemiology of mild/moderate and severe cervical dysplasia. In addition, it suggests consistency between the epidemiology of intraepithelial and invasive cervical neoplasia for risk factors that are likely to act on one of the first stages of the process of carcinogenesis (i.e., indications of sexual habits) but differences for hormone-mediated factors (i.e., reproductive variables or oral contraceptives).

Abortion, Spontaneous↗

Body mass at different ages and subsequent endometrial cancer risk.

The relationship between body mass index (BMI) at different ages and subsequent endometrial-cancer risk was investigated in a multicentre case-control study conducted between 1988 and 1991 in Vaud, Switzerland, and Northern Italy on 272 histologically confirmed incident cases of endometrial cancer and 571 controls admitted to hospital for acute, non-neoplastic conditions, unrelated to known or potential risk factors for endometrial cancer. The risk of endometrial cancer increased with increasing BMI in the 3rd decade of age (20 to 29 years), in the 5th decade (40 to 49 years) and in the 7th decade (60 to 69 years), although the risk estimates tended to be substantially higher at older ages: compared with women whose BMI (kg m-2) was less than 20, the relative risks (RR) were 1.8 for BMI greater than or equal to 25 at age 20 to 29, 2.7 for BMI greater than or equal to 30 at age 40 to 49 and 3.8 at age 60 to 69. All the trends in risk were significant, except that for BMI at age 25 after allowance for current BMI. When data were examined in separate strata of current BMI, among women of normal body mass at diagnosis no significant effect of past overweight was observed. In contrast, among subjects over-weight at diagnosis, there were significant direct relationships with BMI at ages 20 to 29 and 40 to 49. To reduce endometrial cancer risk, it is therefore important to avoid obesity in later middle and older age, and the benefit can be even greater for women who were overweight at younger age.

Age Factors↗

Family history of reproductive cancers and ovarian cancer risk: an Italian case-control study.

The relation between family history of ovarian, breast, and endometrial cancer and risk of epithelial ovarian carcinoma was analyzed within the framework of a case-control study conducted from 1983 to 1989. The study included 755 cases of ovarian cancer and 2,023 controls in hospital for a spectrum of acute nongynecologic, hormonal, or neoplastic conditions in the Greater Milan area, Italy. Eighteen cases (2%) and 24 controls (1%) reported a history of ovarian cancer in a first-degree relative: The corresponding multivariate adjusted odds ratio (OR) was 1.9 (95% confidence interval (CI) 1.1-3.6). The risk of ovarian cancer was elevated in women reporting a family history of breast cancer (OR = 1.6, 95% CI 1.1-2.3), but no significant association emerged with a family history of endometrial cancer (OR = 1.3, 95% CI 0.8-1.7). When the data were stratified by family history of breast cancer, a family history of ovarian cancer was over 10 times more frequent in both cases and controls who reported a family history of breast cancer than in cases and controls reporting no family history of breast cancer. The estimated odds ratio for ovarian cancer associated with a family history of the disease was 2.3 (95% CI 1.1-4.5) in women not reporting a family history of breast cancer, but no association emerged in the subgroup of women reporting a family history of breast cancer. These results confirm that a family history of ovarian cancer increases the risk of the disease, but the percentage of ovarian cancer cases explained by a family history of the disease is small: Less than 1% of observed cases in this study could be attributed to this "family risk factor."

Adult↗