| 11. |
- Petridou, Eleni Th., et al.
(författare)
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In vitro fertilization and risk of childhood leukemia in Greece and Sweden
- 2012
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 58:6, s. 930-936
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Tidskriftsartikel (refereegranskat)abstract
- Background Cancer risk in children born after in vitro fertilization (IVF) remains largely unknown. We aimed to investigate risk of leukemia and lymphoma following IVF using two nationwide datasets. Methods. The hospital-based case-control study in Greece derived from the National Registry for Childhood Hematological Malignancies (1996-2008, 814 leukemia and 277 lymphoma incident cases with their 1: 1 matched controls). The Swedish casecontrol study was nested in the Swedish Medical Birth Register (MBR) (1995-2007, 520 leukemia and 71 lymphoma cases with their 5,200 and 710 matched controls) with ascertainment of incident cancer cases in the National Cancer Register. Study-specific and combined odds ratios (OR) were estimated using conditional logistic regression, with adjustment for possible risk factors. Results. Nationwide studies pointed to similar size excess risk of leukemia following IVF, but to a null association between IVF and lymphoma. The proportion of leukemia cases conceived through IVF was 3% in Greece and 2.7% in Sweden; prevalence of IVF in matched controls was 1.8% and 1.6%, respectively. In combined multivariable analyses, the increased risk of leukemia was confined to age below 3.8 years (OR 2.21; 95% confidence interval, CI: 1.27-3.85) and to acute lymphoblastic leukemia (ALL) (OR 1.77; 95% CI: 1.062.95) with no sufficient evidence of excess risk for other leukemias (OR 1.34; 95% CI: 0.38-4.69). Following IVF, OR for ALL was 2.58 (95% CI: 1.37-4.84) before age 3.8 and 4.29 (95% CI: 1.4912.37) before age 2 years. Conclusions. IVF seems to be associated with increased risk of early onset ALL in the offspring.
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| 12. |
- Sergentanis, Theodoros N., et al.
(författare)
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IVF and breast cancer : a systematic review and meta-analysis
- 2014
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Ingår i: Human Reproduction Update. - : Oxford University Press (OUP). - 1355-4786 .- 1460-2369. ; 20:1, s. 106-123
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUNDThe effects of controlled ovarian hyperstimulation (COH) for IVF in terms of breast cancer risk remain controversial, despite the hormone-dependent nature of the latter.METHODSEligible studies up to 15 February 2013 were identified and pooled effect estimates for relative risk (RR) were calculated separately for the investigations using the general population and those using infertile women, as a reference group. Fixed- or random-effects models were implemented and subgroup analyses were performed, as appropriate.RESULTSEight cohort studies were synthesized, yielding a total cohort size of 1 554 332 women among whom 14 961 incident breast cancer cases occurred, encompassing 576 incident breast cancer cases among women exposed to IVF. No significant association between IVF and breast cancer was observed either in the group of studies treating the general population (RR = 0.91, 95% confidence interval (CI): 0.74–1.11) or infertile women (RR = 1.02, 95% CI: 0.88–1.18), as a reference group. Of note were the marginal associations, protective for pregnant and/or parous women after IVF (pooled effect estimate = 0.86, 95% CI: 0.73–1.01) and adverse for women <30 years at first IVF treatment (pooled effect estimate = 1.64, 95% CI: 0.96–2.80).CONCLUSIONSAt present, COH for IVF does not seem to impart increased breast cancer risk. Longer follow-up periods, comparisons versus infertile women, subgroup analyses aiming to trace vulnerable subgroups, adjustment for various confounders and larger informative data sets are needed before conclusive statements for the safety of the procedure are reached.
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| 13. |
- Siristatidis, Charalampos, et al.
(författare)
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Controlled ovarian hyperstimulation for IVF : impact on ovarian, endometrial and cervical cancer-a systematic review and meta-analysis
- 2013
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Ingår i: Human Reproduction Update. - : Oxford University Press (OUP). - 1355-4786 .- 1460-2369. ; 19:2, s. 105-123
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: In response to the ongoing debate on the long-term effects of assisted reproduction technologies, such as IVF, we systematically reviewed and meta-analyzed available evidence on the association between controlled ovarian hyperstimulation for IVF and risk of ovarian, endometrial and cervical cancer. METHODS: Eligible studies were identified and pooled effect estimates for relative risk (RR) were calculated by cancer type among two reference groups (general population or infertile women), through fixed-or random-effects models as appropriate. RESULTS: Nine cohort studies were synthesized, corresponding to a total size of 109 969 women exposed to IVF, among whom 76 incident cases of ovarian, 18 of endometrial and 207 cases of cervical cancer were studied. The synthesis of studies with general population as the reference group pointed to a statistically significant positive association between IVF and increased risk for ovarian (RR = 1.50, 95% confidence interval (CI): 1.17-1.92) and endometrial (RR = 2.04, 95% CI: 1.22-3.43), but not cervical (RR = 0.86, 95% CI: 0.49-1.49)cancers. On the contrary, when infertile women were used as the reference group, no significant associations with ovarian, endometrial or cervical cancer types were noted (RR=1.26, 95% CI: 0.62-2.55 RR=0.45, 95% CI: 0.18-1.14 and RR= 5.70, 95% CI: 0.28-117.20, respectively). CONCLUSIONS: IVF does not seem to be associated with elevated cervical cancer risk, nor with ovarian or endometrial cancer when the confounding effect of infertility was neutralized in studies allowing such comparisons. Of note, only one study provided follow-up longer than 10 years for the group exposed to IVF. Future cohort studies should preferably use infertile women as the reference group, rely on IVF-registered valid exposure data, adjust for a variety of meaningful confounders and adopt relatively longer follow-up periods before sound conclusions are drawn.
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| 14. |
- Skalkidou, Alkistis, 1977-, et al.
(författare)
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Biological aspects of postpartum depression
- 2012
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Ingår i: Women's health. - : SAGE Publications. - 1745-5065. ; 8:6, s. 659-671
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Tidskriftsartikel (refereegranskat)abstract
- In comparison with the vast epidemiological literature on postpartum depression (PPD), relatively few studies have examined the biological aspects of the disorder. However, research into the biological mechanisms of PPD is a challenging task, as normal pregnancy and the postpartum period cause adaptive endocrine changes, which would otherwise be considered pathological in nonpregnant women. This review focuses on the adaptive changes of childbearing and nursing, which ultimately may put women at increased risk of PPD. In light of the normal physiology, the authors also attempt to describe the current evidence of the biological changes associated with the development of depression in the postpartum period, including ovarian steroids, the hypothalamic-pituitary-adrenal axis, the serotonergic neurotransmitter system, the thyroid system and inflammatory markers. In addition, current knowledge on candidate genes associated with PPD is reviewed.
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| 15. |
- Skalkidou, Alkistis, 1977-, et al.
(författare)
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O-058 46thCongress of the International Society of Paediatric Oncology (SIOP) 2014
- 2014
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 61:S2, s. S121-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives:Birth weight has been explored as a risk factor for several types of childhood (0-14 years) cancer. This nationwide Swedish cohort study aims to evaluate the associationbetween crude and adjusted characteristics of fetal growth (birth weight, length, headcircumference, ponderal index, small-SGA, appropriate-AGA and large for gestational age-LGA) and non-Hodgkin lymphoma (NHL) risk.Methods:All 3,444,136 singleton live births were included, among whom 515 incident NHLcases aged 0-14 years were diagnosed in 1973-2007, as identified through linkage with theSwedish Cancer Register. Proportional hazards models were used to estimate the HazardRatio (HR) and 95% confidence intervals (95% CI) of NHL. The core multivariable modelincluded infant sex, maternal education and maternal age at delivery, birth order of the indexchild (1þchild) and gestational age, the latter omitted in the analyses with SGA, AGA, LGAvariables, as appropriate.Results:Male sex was associated with a doubled NHL risk (HR¼2.00, 95% CI: 1.66-2.41).LGA birth weight, but not birth weightper se, was associated with an 80% increase in NHLrisk (HR¼1.83, 95%CI: 1.20-2.79). In the subgroup analyses by sex, the latter associationwas confined particularly to females (HR¼3.37, 95% CI: 1.90-5.97). Other growth variableswere not consistently associated with NHL risk, prossibly due to smaller variation ormeasurement errors.Conclusions:Fetal macrosomy seems to represent a considerable risk factor for childhoodNHL, whereas its effect may differ by gender. An approach to assess the association solelyusing crude birth weight, as a proxy, seems inadequate, given that more elaborate LGA indicesmay portray accelerated intrauterine growth as a more meaningful component. Future studiesshould aim at disentangling the physiological mechanisms underlying the relevance of sex-specific associations.
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| 16. |
- Sylvén, Sara M, 1982-, et al.
(författare)
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Thyroid function tests at delivery and risk for postpartum depressive symptoms
- 2013
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 38:7, s. 1007-1013
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Tidskriftsartikel (refereegranskat)abstract
- Postpartum depression (PPD) is a common childbirth complication, which can have negative effects on both the newly delivered woman and her family. This condition is underdiagnosed and inadequately treated, while a biological diagnostic test is not yet available. Furthermore, postpartum thyroid dysfunction is common among new mothers, and some evidence point to an association between PPD and thyroid function disturbances. The aim of this study was to evaluate the possible association between serum levels of thyroid hormones at the time of delivery, and the later development of depressive symptoms, using data from a population based cohort of Swedish women. Blood samples were collected during delivery from 347 participating women, delivering at Uppsala University Hospital. The participating women filled in at least one of three structured questionnaires, containing the Edinburgh Postnatal Depression Scale (EPDS), at five days, six weeks and six months postpartum. A cut-off of 12 or more was applied on the EPDS, to identify cases of self-reported PPD and controls. Using a binary logistic regression model (adjusting for previous psychiatric contact, smoking during pregnancy, pre-pregnancy body mass index (BMI) and sleep), having a thyroid stimulating hormone (TSH) level over the clinical cut-off level of 4.0mU/L was associated with increased risk for depressive symptoms at six months postpartum (OR 11.30, 95% CI 1.93-66.11). A ROC analysis revealed that the predictive variable (PV) had significant predictive ability for PPD at 6 months postpartum, given that the AUC was 0.764, and at a PV cut-off value of 6.33, the sensitivity and specificity were 76.2% and 69.4%, respectively. If these findings are replicated in future studies, they can have important clinical implications, since TSH determination is an inexpensive routine blood test, and its inclusion in a biological screening test for PPD involving other parameters would be tempting.
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| 17. |
- Öberg, Mariella, 1970-, et al.
(författare)
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Prevalence of intimate partner violence among women seeking termination of pregnancy compared to women seeking contraceptive counseling
- 2014
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 93:1, s. 45-51
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To estimate the prevalence of intimate partner violence among women seeking termination of pregnancy (TOP) in comparison to women seeking contraceptive counseling.DESIGN:Case-control study.SETTING:Family planning unit, Uppsala University Hospital.POPULATION:Women seeking TOP (n=635) and women seeking contraceptive counseling (n=591) answered a self-administered questionnaire regarding experience of intimate partner violence. In addition, the women were interviewed by specially trained staff.METHOD:Comparisons were made between the two groups and between those who had previously undergone TOP and those who had never done so with experience of intimate partner violence as the main outcome measure. Multivariate logistic regression was used to adjust for age, education, and occupation.RESULTS:In total 29% of women seeking TOP and 22% of women seeking contraceptive counseling reported experience of violence. Women seeking TOP were more likely to report physical violence (adjusted odds ratio (aOR)=1.6, 95% confidence interval (Cl) 1.2-2.1) and experience of violence during the past year (aOR=2.3, 95%Cl 1.1-4.8). Women who had ever undergone TOP were also more likely to report intimate partner violence compared to women with no history of TOP (aOR=1.7, 95%CI 1.3-2.3). Among women with repeated TOP, 51% reported experience of intimate partner violence.CONCLUSION:Women seeking TOP reported to a greater extent experience of intimate partner violence. However, women seeking contraceptive counseling had also a high prevalence of violence experiences. These results stress the importance of caregivers approaching both groups of women with questions about intimate partner violence in order to identify exposed women and offer them help.
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