Marshall, Cassondra (Cassie)
Ferrara, Assiamira
Understanding the risk of ectopic pregnancies among people seeking abortion: a retrospective case control study
This study aims to assess the incidence of ectopic pregnancy among people wanting pregnancy compared to people seeking abortion. The specific research questions are: Are people seeking abortion at lower risk of experiencing an ectopic pregnancy compared to people not…
Standardized ultrasound-based risk stratification for detection of ovarian cancer
This project, initiated in 2014, led to the development and large-scale implementation of a system for risk stratifying ovarian abnormalities seen on ultrasound to ensure that similar abnormalities are described in a similar way by radiologists. The system also allows…
Design of the Association of Uterine Perforation and Expulsion of IUD (APEX-IUD) Study: A Multisite Retrospective Cohort Study
Intrauterine devices are effective and safe, long-acting reversible contraceptives, but the risk of uterine perforation occurs with an estimated incidence of 1 to 2 per 1000 insertions. The European Active Surveillance Study for Intrauterine Devices, a European prospective observational study…
Understanding Barriers to Reproductive Health Care among Women with Autism Spectrum Disorder
This project will examine both reproductive health disparities and OB/GYN health care gaps for 2300 adolescent and adult women with Autism Spectrum Disorder (ASD) receiving care at Kaiser Permanente Northern California, paying particular attention to differences across sociodemographic characteristics, co-occurring…
Why Do Epidemiologic Studies Find an Inverse Association Between Intraprostatic Inflammation and Prostate Cancer: A Possible Role for Colliding Bias?
Inflammation is an emerging risk factor for prostate cancer based largely on evidence from animal models and histopathologic observations. However, findings from patho-epidemiologic studies of intraprostatic inflammation and prostate cancer have been less supportive, with inverse associations observed in many…
Implementation of a Multidisciplinary Expert Testicular Cancer Tumor Board Across a Large Integrated Healthcare Delivery System Via Early Case Ascertainment
In 2016, Kaiser Permanente Northern California began regionalizing testicular cancer care using population-based tumor board review. This mixed methods evaluation describes implementation outcomes and learnings. We conducted in-depth interviews with key stakeholders, administered surveys to local oncologists and urologists, and…
Associations between Prediagnostic Concentrations of Circulating Sex Steroid Hormones and Liver Cancer Among Post-Menopausal Women
In almost all countries, incidence rates of liver cancer (LC) are 100%-200% higher in males than in females. However, this difference is predominantly driven by hepatocellular carcinoma (HCC), which accounts for 75% of LC cases. Intrahepatic cholangiocarcinoma (ICC) accounts for…
Changes in Days of Unhealthy Alcohol Use and Antiretroviral Therapy Adherence, HIV RNA Levels, and Condomless Sex: A Secondary Analysis of Clinical Trial Data
In a sample of people with HIV (PWH) enrolled in an alcohol intervention trial and followed for 12 months, we examined the association of changes in days (i.e., decrease, increase, no change [reference]) of unhealthy drinking (consuming ≥ 4/≥ 5 drinks for women/men) with…
Prediction of Occult Uterine Sarcoma prior to Hysterectomy for Women with Leiomyoma or Abnormal Bleeding
To develop a risk prediction model for occult uterine sarcoma using preoperative clinical characteristics in women undergoing hysterectomy for presumed uterine leiomyomata. Cases of uterine sarcoma were identified from the electronic medical records. Age/race-matched controls were selected at a 2:1…
Prediagnosis social support, social integration, living status, and colorectal cancer mortality in postmenopausal women from the women’s health initiative
We evaluated associations between perceived social support, social integration, living alone, and colorectal cancer (CRC) outcomes in postmenopausal women. The study included 1431 women from the Women's Health Initiative who were diagnosed from 1993 through 2017 with stage I through…
Lights on MsFLASH: a review of contributions
The Menopause Strategies: Finding Lasting Answers for Symptoms and Health clinical trials network was funded by the National Institutes of Health to find new ways to alleviate the most common, bothersome menopausal symptoms by designing and conducting multiple concurrent clinical…
The Effect of Gestational Weight Gain Across Reproductive History on Maternal Body Mass Index in Midlife: The Study of Women’s Health Across the Nation
Background: Excessive weight gain during pregnancy is common and has been shown to be associated with increased long-term maternal weight. However, less is known on whether there is a cumulative effect of excessive gestational weight gain (GWG) over multiple pregnancies.…
Sexual function, menopausal symptoms, depression and cancer worry in women with BRCA mutations
Assess sexual function, menopausal symptoms, and depression in women with BRCA mutations associated with oophorectomy and menopause status. Women age 40 and older with BRCA mutations completed a questionnaire with validated measures of sexual activity, menopausal symptoms, depression, and cancer…
Serum bone markers and risk of osteoporosis and fragility fractures in women who received endocrine therapy for breast cancer: a prospective study
Osteoporosis and fragility fracture are major bone toxicities of aromatase inhibitors (AIs) for postmenopausal hormone receptor-positive breast cancer. Except for a few small studies on bone turnover markers and reduced bone mineral density after AI treatment, data on the associations…
Outcomes of Robotic Hysterectomy for Treatment of Benign Conditions: Influence of Patient Complexity
Robotic hysterectomy may offer advantages for complex cases over the conventional laparoscopic approach. To assess the association of surgical approach (robotic vs conventional) with blood loss, risks of readmission, reoperation, complications, and average operative time. In a retrospective cohort study,…
Identifying and Prioritizing Chemicals with Uncertain Burden of Exposure: Opportunities for Biomonitoring and Health-Related Research
The National Institutes of Health's Environmental influences on Child Health Outcomes (ECHO) initiative aims to understand the impact of environmental factors on childhood disease. Over 40,000 chemicals are approved for commercial use. The challenge is to prioritize chemicals for biomonitoring…
Near Real-Time Surveillance to Assess the Safety of the 9-Valent Human Papillomavirus Vaccine
Human papillomavirus is the most common sexually transmitted infection in the United States and causes certain anogenital and oropharyngeal cancers. The 9-valent human papillomavirus vaccine (9vHPV) provides protection against additional types not included in the quadrivalent vaccine. We conducted near…
Haloperidol and Prostate Cancer Prevention: More Epidemiologic Research Needed
The antipsychotic drug haloperidol has antiproliferative and growth-inhibiting properties on prostate cancer cell lines in vitro by binding the sigma 1 protein. Evidence is needed regarding a possible preventive association in men. To examine whether our epidemiologic data support an…
Facebook advertising for recruitment of midlife women with bothersome vaginal symptoms: A pilot study
The MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) Network recruited into five randomized clinical trials (n = 100-350) through mass mailings. The fifth trial tested two interventions for postmenopausal vulvovaginal symptoms (itching, pain, irritation, dryness, or pain with sex)…
Fetal Programming of Growth and Obesity: A Metabolomics Approach
This proposal uses a novel holistic framework that leverages both targeted and untargeted metabolomics approach, electronic health records data, and bioinformatics analytics to investigate the mechanisms by which the in-utero environment may infer risk of fetal growth extremes and altered…
Sex and Race/Ethnicity-specific Multilevel Factors Influencing Pubertal Trajectories: A Population-based Study
The goal of this project is to describe the normative distributions of pubertal development among boys and girls by race/ethnicity and to investigate early-life risk factors affecting pubertal onset and tempo (velocity of transition between onset and maturation). We will…
PQ3 Cutaneous Squamous Cell Carcinoma: Integrating Germline and Somatic Alterations that Underlie Tumor Progression
The goal of this proposal is to compare tumor versus normal samples of cutaneous squamous cell carcinoma in a large cohort of approximately 77,578 Kaiser Permanente Northern California members. Our goal is to improve understanding of the mechanisms accounting for…
Depot Medroxyprogesterone Acetate, Oral Contraceptive, Intrauterine Device Use, and Fracture Risk
To assess fracture risk among women with depot medroxyprogesterone acetate (DMPA), oral contraceptive pill (OCP), and intrauterine device (IUD) use. A retrospective cohort study of 308,876 women age 12-45 years who initiated DMPA, combined or progestin-only OCPs, and copper and…
Longitudinal study of age of menarche in association with childhood concentrations of persistent organic pollutants
Age at female puberty is associated with adult morbidities, including breast cancer and diabetes. Hormonally active chemicals are suspected of altering pubertal timing. We examined whether persistent organic pollutants (POPs) are associated with age at menarche in a longitudinal study.…
Trichomonas vaginalis infection and prostate-specific antigen concentration: Insights into prostate involvement and prostate disease risk.
BACKGROUND: The protist Trichomonas vaginalis causes a common, sexually transmitted infection and has been proposed to contribute to the development of chronic prostate conditions, including benign prostatic hyperplasia and prostate cancer. However, few studies have investigated the extent to which…
Sexual frequency and pain in a randomized clinical trial of vaginal estradiol tablets, moisturizer, and placebo in postmenopausal women
To evaluate the efficacy of two common interventions for bothersome postmenopausal vaginal symptoms on improving sexual frequency and pain. This is a post-hoc analysis of data from a 12-week double-blind placebo-controlled trial that randomized postmenopausal women (ages 45-70 years) with…
Understanding periviable birth: A microeconomic alternative to the dysregulation narrative
Periviable infants (i.e., those born in the 20th through 26th weeks of gestation) suffer much morbidity and approximately half die in the first year of life. Attempts to explain and predict these births disproportionately invoke a "dysregulation" narrative. Research inspired…
Predictors of Long-Term Survival among High-Grade Serous Ovarian Cancer Patients
Relatively little is known about factors associated with long-term survival (LTS) following a diagnosis of ovarian cancer. We conducted a retrospective study of high-grade serous ovarian cancer (HGSOC) to explore predictors of LTS (defined as ≥7 years of survival) using…
Barriers to preexposure prophylaxis use among individuals with recently acquired HIV infection in Northern California
Barriers to HIV preexposure prophylaxis (PrEP) use have not been well-characterized in people who became HIV-infected, all of whom could have benefited from PrEP. We invited Kaiser Permanente Northern California members diagnosed with HIV during 2014-2016, following a negative HIV…
Reproductive period and risk of dementia in a diverse cohort of health care members
Women have >50% greater lifetime risk of dementia than men but the role of female-specific endocrine milieu is not well-understood. This study evaluates associations between indicators of estrogen exposure from women's reproductive period and dementia risk in a large diverse…
Maternal Gestational Weight Gain, Obesity, and the Timing of Pubertal Onset in Daughters
Early puberty is associated with adverse health outcomes, but little is known regarding early life determinants influencing pubertal timing. We examined the associations between maternal gestational weight gain (GWG) and the timing of the onset of breast development (thelarche) and…
Changes in body composition and weight during the menopause transition
The relation between the menopause transition (MT) and changes in body composition or weight remains uncertain. We hypothesized that, independent of chronological aging, the MT would have a detrimental influence on body composition. Participants were from the longitudinal Study of…
Long-term follow-up of pediatric open and laparoscopic inguinal hernia repair
Pediatric laparoscopic inguinal hernia repair is not widely accepted. Children 0-14 years who underwent inguinal hernia repair during 2010-2016 at Kaiser Permanente Northern California were classified into five groups: (1) open unilateral repair without contralateral exploration; (2) open unilateral repair with…
Pill, patch, or ring? A mixed methods analysis of provider counseling about combined hormonal contraception
In this study we aimed to investigate the content and process of contraceptive counseling surrounding combined hormonal contraceptive (CHC) methods (combined oral contraceptives, the ring, and the patch). We performed a mixed methods analysis of data collected as part of…
Bisphenol A Exposure and Sperm ACHE Hydroxymethylation in Men
Exposure to bisphenol A (BPA) has been shown to impact human sperm quality. The epigenetic mechanisms underlying the effect remain unknown. The acetylcholinesterase (ACHE) gene is a sperm-expressed gene encoding the acetylcholine hydrolyzing enzyme acetylcholinesterase and participates in the apoptosis…
Identification and validation of uterine perforation, intrauterine device expulsion, and breastfeeding in four health care systems with electronic health records
To validate algorithms identifying uterine perforations and intrauterine device (IUD) expulsions and to ascertain availability of breastfeeding status at the time of IUD insertion. Four health care systems with electronic health records (EHRs) participated: Kaiser Permanente Northern California (KPNC), Kaiser…
The Association of Polycystic Ovary Syndrome and Gestational Hypertensive Disorders in a Diverse Community-Based Cohort
To examine the association of polycystic ovary syndrome (PCOS) and pregnancy-induced hypertension (PIH) within a large population of pregnant women in an integrated healthcare system. This retrospective study utilized a source cohort of 1023 women with PCOS and 1023 women…
Study on the Association of Uterine Perforation and IUD expulsion With Breastfeeding Status at the Time of IUD insertion and Postpartum Timing of IUD Insertion in Electronic Medical Record Databases – A Post-marketing Requirement for Mirena
The Food and Drug Administration (FDA) has required Bayer AG to conduct a post-marketing study in the U.S. to determine the incidence of uterine perforation and IUD expulsion by type of intrauterine device (IUD) used. The goal of this study…
Adolescent and Young Adult Female Cancer Survivors – Cancer Experience Survey
This study aims to: 1) assess reproductive intentions and receipt of fertility counseling or preservation in relation to post-diagnosis birth outcomes among adolescent and young adult cancer survivors in North Carolina and the Kaiser Permanente Northern California and Kaiser Permanente…
Incidence and Trend of Ectopic Pregnancy and Contraceptive Use
Incidence and management of ectopic pregnancy have undergone significant changes in recent decades. There is a general consensus that available effective contraceptive methods reduce the absolute risk of ectopic pregnancy. Ectopic pregnancy incidence rate has not been well-documented in the…
Genetic variation in the SIM1 locus is associated with erectile dysfunction
Erectile dysfunction affects millions of men worldwide. Twin studies support the role of genetic risk factors underlying erectile dysfunction, but no specific genetic variants have been identified. We conducted a large-scale genome-wide association study of erectile dysfunction in 36,649 men…
Contraception after Abortion and Risk of Repeated Unintended Pregnancy among Health Plan Members
Optimizing access to effective contraception at the time of abortion can reduce repeated unintended pregnancies. To assess contraception initiation and repeated unintended pregnancies among women receiving abortions in Kaiser Permanente Northern California (KPNC) facilities and through outside contracted facilities. A…
Use of non-steroidal anti-inflammatory drugs during pregnancy and the risk of miscarriage
Nonsteroidal antiinflammatory drugs are among the medications most widely used by pregnant women, and previous studies have reported an increased risk of miscarriage that is associated with nonsteroidal antiinflammatory drug use during pregnancy. Although the findings have not always been…
Association of Bisphenol A Exposure with LINE-1 Hydroxymethylation in Human Semen
Bisphenol A (BPA), an exogenous endocrine-disrupting chemical, has been shown to alter DNA methylation. However, little information is available about the effect of BPA exposure on DNA hydroxymethylation in humans. The objective of the present study was to examine whether…
Cardiorespiratory Fitness, Exercise Hemodynamics and Birth Outcomes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Determine associations of cardiorespiratory fitness, exercise systolic blood pressure (SBP) and heart rate recovery (HRR) following a maximal exercise test performed years preceding pregnancy with odds of preterm birth (PTB;
Effect of Maternal Influenza Vaccination during Pregnancy on Risk of Infant Influenza
This project has three major aims: 1) to examine whether influenza vaccination during pregnancy prevents influenza and other respiratory infections in infants aged 0 to 12 months, with a sub-aim to examine the effect of vaccine timing during pregnancy on…
Scientific abstracts featured research at the 2018 North American Forum on Family Planning
The Society of Family Planning (SFP), Planned Parenthood Federation of America (PPFA), and the Association of Reproductive Health Professionals (ARHP) are delighted to host the eighth annual North American Forum on Family Planning (the Forum) in New Orleans, LA, from…
The Relationship Between Prescription Copayments and Contraceptive Adherence in a New-user Cohort
Contraceptive nonadherence is an important contributor to unintended pregnancy in the United States. While the elimination of patient cost sharing has been cited as means to improve contraceptive access, little is known about the relationship between cost sharing and ongoing…
Associations Between Maternal Obesity and Pregnancy Hyperglycemia and Timing of Pubertal Onset in Adolescent Girls: A Population-Based Study
Early puberty is associated with adverse health outcomes. We investigated whether in utero exposure to maternal obesity is associated with daughters' pubertal timing using 15,267 racially/ethnically diverse Kaiser Permanente Northern California members aged 6-11 years with pediatrician-assessed Tanner staging (2003-2017).…
Maternal sedentary behavior during pre-pregnancy and early pregnancy and mean offspring birth size: a cohort study
Sedentary behavior is associated with adverse health outcomes in the general population. Whether sedentary behavior during pregnancy is associated with newborn outcomes, such as birth size, is not established, and previous studies have been inconsistent. While previous research suggests that…
Sustained influence of infections on prostate-specific antigen concentration: An analysis of changes over 10 years of follow-up.
BACKGROUND: To extend our previous observation of a short-term rise in prostate-specific antigen (PSA) concentration, a marker of prostate inflammation and cell damage, during and immediately following sexually transmitted and systemic infections, we examined the longer-term influence of these infections,…
Large-Scale Implementation of Structured Reporting of Adnexal Masses on Ultrasound
The aim of this article is to describe the development and implementation of structured reporting of adnexal mass findings on pelvic ultrasound in a large integrated health care delivery system. A structured reporting system that includes standardized terminology for describing…
Association between paternal alcohol consumption before conception and anogenital distance of offspring
There are limited studies on the effects of paternal alcohol consumption, before conception, on the reproductive development of offspring. Anogenital distance (AGD), the distance from the center of the anus to the genitals, is a sensitive biomarker of reproductive hormone…
Predictors of Follow-Up Visits Post Radical Prostatectomy.
Long-term follow-up care among prostate cancer patients is important as biochemical recurrence can occur many years after diagnosis, with 20%-30% of men experiencing biochemical recurrence within 10 years of treatment. This study examined predictors of follow-up care among 1,158 radical…
Exploring young women’s decisional needs for contraceptive method choice: A qualitative study
Assisting women with choosing contraceptive methods that meet their needs and preferences is essential to providing patient-centered care, but research to inform interventions supporting method choice is lacking. An assessment of patient decisional needs for contraceptive method choice may provide…
Early Detection of Obstetric Complications: Development of Predictive Models Suitable for Real-Time Surveillance During Labor, Delivery, and the Postpartum Period
This is a feasibility study to determine whether data from Kaiser Permanente HealthConnect® can be harnessed to predict obstetric complications in real time. The long-term goal is to develop algorithms that could be instantiated in the electronic record to provide…
Autism spectrum disorder and birth spacing: Findings from the study to explore early development (SEED)
Previous studies of autism spectrum disorder (ASD) and birth spacing had limitations; few examined phenotypic case subtypes or explored underlying mechanisms for associations and none assessed whether other (non-ASD) developmental disabilities (DDs) were associated with birth spacing. We assessed associations…
Exposure to Magnetic Field Non-Ionizing Radiation and the Risk of Miscarriage: A Prospective Cohort Study
Magnetic field (MF) non-ionizing radiation is widespread and everyone is exposed to some degree. This prospective cohort study of 913 pregnant women examined the association between high MF exposure and miscarriage risk. Cox (proportional hazards) regression was used to examine…
Autism risk classification using placental chorionic surface vascular network features
Autism Spectrum Disorder (ASD) is one of the fastest-growing developmental disorders in the United States. It was hypothesized that variations in the placental chorionic surface vascular network (PCSVN) structure may reflect both the overall effects of genetic and environmentally regulated…
Clinical Pregnancy Outcomes in Adolescent and Young Adult Female Cancer Survivors
Post-diagnosis fertility is a critical issue for adolescent and young adult cancer survivors (diagnosed at age 15 to 39 years), with little information on the impact of cancer diagnosis and treatment on pregnancy outcomes. This study focuses on five leading…
Opportunities to Reduce Diabetes Risk in Women of Reproductive Age: Assessment and Treatment of Prediabetes within a Large Integrated Delivery System
Preventing diabetes before pregnancy may be important to improve maternal and infant outcomes. Although the preconception period is a crucial time to focus on chronic disease prevention, little is known about preventive services for reproductive-aged women at risk of developing…
Urine leakage during sexual activity among ethnically diverse, community-dwelling middle-aged and older women
Urinary incontinence is associated with decreased female sexual function, but little is known about the prevalence, predictors, and impact of urine leakage during sexual activity among women in the community. The purpose of this study was to evaluate the prevalence…
Maternal and Paternal Infertility Disorders and Treatments and Autism Spectrum Disorder: Findings from the Study to Explore Early Development
Previous studies of associations between ASD and conception using assisted reproductive technology (ART) are inconsistent and few studies have examined associations with other infertility treatments or infertility disorders. We examined associations between ASD and maternal/paternal infertility disorders and numerous maternal…
Age at Pubertal Onset in Girls and Tobacco Smoke Exposure during Pre- and Post-natal Susceptibility Windows
Tobacco smoke contains known hormonally active chemicals and reproductive toxicants. Several studies have examined prenatal maternal smoking and offspring age at menarche, but few examined earlier pubertal markers, nor accounted for exposure during childhood. Our objective was to examine pre-…
Healthy Lifestyle During Early Pregnancy and Risk of Gestational Diabetes Mellitus
Previous studies have found associations between individual healthy behaviors and reduced risk of gestational diabetes mellitus (GDM); however, the association of composite healthy lifestyle during pregnancy with GDM has not been examined. Participants in the Omega Study (n = 3,005),…
Anti-Müllerian hormone, follicle stimulating hormone, antral follicle count, and risk of menopause within 5 years
To evaluate the ability of concentration of anti-Müllerian hormone (AMH), antral follicle count (AFC), and concentration of follicle stimulating hormone (FSH) to predict the onset of menopause. The Coronary Artery Risk Development in Young Adults Study (CARDIA) Women's Study was…
Peripubertal dietary flavonol and lignan intake and age at menarche in a longitudinal cohort of girls
BackgroundDietary phytoestrogens may alter hormonal activity in childhood. Flavonols and lignans are the most prevalent phytoestrogens in the Western diet. We examined whether higher intake of flavonols and lignans was associated with later age at menarche in a prospective study…
Urinary bisphenol A and pubertal development in Chinese school-aged girls: a cross-sectional study
Animal studies suggest that bisphenol A (BPA) may perturb pubertal development in females. However, evidence from human studies is limited. This was a cross-sectional study to investigate the association between BPA exposure and pubertal development in school-aged girls. A total…
Impact of body mass index on ovarian cancer survival varies by stage
Research on the effect of body mass index (BMI) on ovarian cancer survival is inconsistent, but previous studies did not consider the possible impact of ascites, bowel obstruction, or cachexia, which commonly occur in late-stage disease. We evaluated the association…
Minimally Invasive Hysterectomy and Power Morcellation Trends in a West Coast Integrated Health System
To examine trends in minimally invasive hysterectomy and power morcellation use over time and associated clinical characteristics. We conducted a trend analysis and retrospective cohort study of all women 18 years of age and older undergoing hysterectomy for benign conditions…
Are Health Plan Design and Prior Use of Long-Acting Reversible Contraception Associated with Pregnancy Intention?
In 2007, high-deductible plans were added to the primarily nondeductible Kaiser Permanente Northern California (KPNC) integrated health plan, which had covered 100% of device and procedure costs of long-acting reversible contraception (LARC) for members regardless of prescription/visit copay amount. We…
Weight fluctuation and cancer risk in post-menopausal women: The Women’s Health Initiative
Background: Weight cycling, defined by an intentional weight loss and subsequent regain, commonly occurs in overweight and obese women and is associated with some negative health outcomes. We examined the role of various weight-change patterns during early to mid-adulthood and…
Shared decision making in contraceptive counseling
Shared decision making (SDM) is a potentially valuable but underexplored approach to contraceptive counseling. We determined the correlation between patient report of SDM and of whether their provider had a method preference with measures of satisfaction. Women reporting SDM were…
Maternal healthy lifestyle during early pregnancy and offspring birthweight: differences by offspring sex
PURPOSE: Individual maternal lifestyle factors during pregnancy have been associated with offspring birthweight; however, associations of combined lifestyle factors with birthweight and potential differences by offspring sex have not been examined. MATERIALS AND METHODS: Participants (N = 2924) were identified from a…
Over-the-Counter Access to Oral Contraceptives for Adolescents
Oral contraceptives (OCs) are used by millions of women in the U.S. The requirement to obtain OCs by prescription from a clinician may serve as a barrier to contraceptive initiation and continuation for women, in particular adolescents. Over-the-counter (OTC) availability…
Multiethnic Study of Breast Arterial Calcium Gradation and CVD
Specific study aims are: 1) To establish a multi-ethnic cohort between the ages of 60 and 79 years with equal representation of white, African-American, Asian and Hispanic/Latina women. All participants will be recruited at the time of their regular screening…
Pregnancy-Related Risk Factors and Glucose Intolerance in Women during Midlife
This is an ancillary study to the CARDIA Study, a multi-center longitudinal study of 5,115 black and white women and men (18-30) enrolled in 1985-1986, and followed at in-person exams serially through 2011. The study will evaluate pregnancy-related changes in…
Incidence of Osteoporosis and Abnormal Lipid Profiles in Women Over Age 40, Who Test Positive for a BRCA1 or BRCA2 Mutation and Have Had a Risk-Reducing Salpingo-oophorectomy
This cohort study will use DXA scans to: 1) establish the incidence of abnormal DXA scans in women post testing positive for BRCA1 or 2 mutations who have undergone risk-reducing salpingo-oophorectomy (RRSO); and 2) identify risk factors for abnormal DXA…
Kaiser Permanente PROSPR Cervical Cancer Prevention and Screening (CCaPS) Center
The purpose of this project is to expand PROSPR's activities related to screening women for cervical cancer. PROSPR is the National Cancer Institute's Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. This specific application will extend an existing collaboration…
Collection of Discarded Cervical Cancer Screening Specimens
Despite HPV vaccines, screening will remain central for decades to control cervical cancer. Recently, HPV testing alone or with cytology was introduced in the US as an alternative to cytology screening. However, most HPV infections are harmless and additional tests…
HPV Impact Typing Study (HiTS) part II, 2015-2017
This is a follow-up study of of a previous study which evaluated HPV type prevalence in residual cervical specimens from screening. The current study will measure the impact of HPV typing ollowing the introduction of the human papillomavirus vaccine. This…
Risk of Uterine Perforation among Women Using different types of IUDs and the Association with Timing of Insertion and Breastfeeding
The goal of the study is to compare the incidence of uterine perforation within 12 months after IUD insertion between: (1) postpartum insertions within 12 months of delivery (with breastfeeding status), (2) post abortion or pregnancy loss IUD insertions and…
Provider self-disclosure during contraceptive counseling
Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized in the context of contraceptive counseling. In this study, we describe the incidence, content and context of contraceptive PSD. This…
Patient perceptions of a decision support tool to assist with young women’s contraceptive choice
Contraceptive decision support tools (DSTs) have been suggested as a way to provide patient-centered contraceptive care, but little is known about the role they play in women's decision-making. The aim of this study is to understand patients' perceptions of the…
Engaging At-Risk Minority Women in Health System Diabetes Prevention Programs
The potential for efficacious lifestyle interventions to prevent type 2 diabetes hinges on patient engagement in real-world healthcare settings. Yet patient engagement strategies are suboptimal and attrition is often highparticularly concerning for ethnic minority women who bear disproportionate burdens of…
Contraceptive Clinical Trials Network – DUPLICATED DO NOT ACTIVATE
The NICHD Contraceptive Clinical Trials Network (CCTN) will consist of up to 16 sites capable of performing female contraceptive clinical trials. Each site will work with the CCTN Statistical and Clinical Coordinating Center and NICHD to rapidly develop protocols and…
WHI Cancer Survivor Cohort
The primary goal of this research project is to create an infrastructure within WHI to build a resource for the study of molecular epidemiology and cancer survivorship. Cancer survivors will be followed annually with surveys; tumor tissue will be acquired;…
Appropriate Gestational Weight Gain in Overweight/Obese Women
Among overweight/obese pregnant women, we propose to develop and evaluate a randomized diet and physical activity intervention tailored to mothers and feasible in a health plan setting, with the goal of ameliorating inappropriate gestational weight gain.
MsFLASH: Living a Healthy Menopause
The aims of this study are: 1) Conduct a 4-arm, double-blind, placebo-controlled randomized trial among postmenopausal women with vaginitis symptoms (moderate/severe vaginal dryness, burning, itching, pain or dyspareunia in the absence of infection) to compare the efficacy of: (a) the…
Plan B 1.5 Actual Use Emergency Contraception Study
Guidance on the use of data collected for the clinical trial of Protocol DR-LEV-302 for clinical audits with the sponsor, FDA audits, and development of any reports or manuscripts related to the study protocol.
Contraceptive Clinical Trials Network
The NICHD Contraceptive Clinical Trials Network (CCTN) will consist of up to 16 sites capable of performing female contraceptive clinical trials. Each site will work with the CCTN Statistical and Clinical Coordinating Center and NICHD to rapidly develop protocols and…
Proximity to major roadways and prospectively-measured time-to-pregnancy and infertility.
We aimed to study the potential impact of proximity to major roadways on time-to-pregnancy and infertility in couples attempting pregnancy in the Longitudinal Investigation of Fertility and Environment (LIFE) study (2005-2009), a population-based, prospective cohort study. Couples attempting pregnancy (n=500)…
Multiethnic Study of Breast Arterial Calcium Gradation and CVD – DUPLICATED DO NOT ACTIVATE
To establish a multi-ethnic cohort (n=5,400) between the ages of 60 and 79 years with equal representation of white (n=1,350; 25%), African-American (n=1,350; 25%), Asian (n=1,350; 25%) and Hispanic/Latina (n=1,350; 25%) women. All participants will be recruited at the time…
Study of Womens Health Across the Nation (SWAN): UC Davis and Kaiser Permanente
The objective of this project is to follow a large multi-ethnic sample of premenopausal women through the menopausal transition, in order to investigate the influence of biological and social and cultural factors on age at menopause, symptoms of menopause and…
Risk of Type 2 Diabetes Mellitus following Gestational Diabetes Pregnancy in Women with Polycystic Ovary Syndrome
This study examines gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS) and the risk of type 2 diabetes mellitus (DM) following GDM pregnancy. A cohort of 988 pregnant women with PCOS who delivered during 2002-2005 was examined…
Gravidity is not associated with telomere length in a biracial cohort of middle-aged women: The Coronary Artery Risk Development in Young Adults (CARDIA) study
Having experienced 2-3 births is associated with reduced mortality versus women with
Genome-wide alteration in DNA hydroxymethylation in the sperm from bisphenol A-exposed men
Environmental BPA exposure has been shown to impact human sperm concentration and motility, as well as rodent spermatogenesis. However, it is unclear whether BPA exposure is associated with alteration in DNA hydroxymethylation, a marker for epigenetic modification, in human sperm.…
Associations of urinary phthalate and phenol biomarkers with menarche in a multiethnic cohort of young girls
To study potential environmental influences on puberty in girls, we investigated urinary biomarkers in relation to age at menarche. Phenols and phthalates were measured at baseline (6-8 years of age). Menarche was ascertained over 11 years for 1051 girls with…
Genome-wide analysis identifies 12 loci influencing human reproductive behavior
The genetic architecture of human reproductive behavior-age at first birth (AFB) and number of children ever born (NEB)-has a strong relationship with fitness, human development, infertility and risk of neuropsychiatric disorders. However, very few genetic loci have been identified, and…
Deep sequencing of HPV16 genomes: A new high-throughput tool for exploring the carcinogenicity and natural history of HPV16 infection
For unknown reasons, there is huge variability in risk conferred by different HPV types and, remarkably, strong differences even between closely related variant lineages within each type. HPV16 is a uniquely powerful carcinogenic type, causing approximately half of cervical cancer…
Urinary N-Telopeptide and Rate of Bone Loss Over the Menopause Transition and Early Postmenopause
The purpose of this study was to assess the ability of urinary N-telopeptide (U-NTX) to gauge rate of bone loss across and after the menopause transition (MT). U-NTX measurement was measured in early postmenopause in 604 participants from the Study…
Residential proximity to traffic and female pubertal development
Traffic-related air pollution (TRAP) has been linked with several adverse health outcomes, including preterm birth and low birth weight, which are both related to onset of puberty. No studies to date have investigated the association between TRAP and altered pubertal…
Experience With Opportunistic Salpingectomy in a Large, Community-Based Health System in the United States
To evaluate the trend in uptake of salpingectomy at the time of hysterectomy and assess physicians' attitudes toward the practice. This was a retrospective cohort study using the electronic medical record to identify women 18 years of age or older…
Dual energy X-ray absorptiometry spine scans to determine abdominal fat in postmenopausal women
Body composition may be a better predictor of chronic disease risk than body mass index (BMI) in older populations.OBJECTIVES:We sought to validate spine fat fraction (%) from dual energy X-ray absorptiometry (DXA) spine scans as a proxy for total abdominal…
Associations Between Maternal Pregravid Obesity and Gestational Diabetes and the Timing of Pubarche in Daughters
We investigated whether in utero exposure to maternal pregravid obesity and/or gestational diabetes mellitus (GDM) was associated with early puberty in girls. We used data from a longitudinal study of 421 mother-daughter pairs enrolled in an integrated health services organization,…
Telephone-Based Cognitive Behavioral Therapy for Insomnia in Perimenopausal and Postmenopausal Women With Vasomotor Symptoms: A MsFLASH Randomized Clinical Trial
Effective, practical, nonpharmacologic therapies are needed to treat menopause-related insomnia symptoms in primary and women's specialty care settings. To evaluate the efficacy of telephone-based cognitive behavioral therapy for insomnia (CBT-I) vs menopause education control (MEC). A single-site, randomized clinical trial…
The role of human papillomavirus (HPV) genotyping in cervical cancer screening: A large-scale evaluation of the cobas HPV test
The cobas?HPV Test ("cobas", Roche Molecular Systems) detects HPV16 and HPV18 individually, and a pool of 12 other high-risk (HR) HPV types. The test is approved for 1) ASC-US triage to determine need for colposcopy, 2) combined screening with cytology…
Development of a Brief Questionnaire to Assess Contraceptive Intent
We sought to develop and validate an instrument that can enable providers to identify young women who may be at risk of contraceptive non-adherence. Item response theory based methods were used to evaluate the psychometric properties of the Contraceptive Intent…
Preterm Delivery and Metabolic Syndrome in Women Followed From Prepregnancy Through 25 Years Later
To investigate whether women who deliver preterm have excess risk for metabolic dysregulation independent of prepregnancy factors. We conducted a multicenter, longitudinal, observational study of 1,205 women (50% black) in the Coronary Artery Risk Development in Young Adults study with…
Reproductive Risk Factors and Coronary Heart Disease in the Women’s Health Initiative Observational Study
Reproductive factors provide an early window into a woman's coronary heart disease (CHD) risk; however, their contribution to CHD risk stratification is uncertain. In the Women's Health Initiative Observational Study, we constructed Cox proportional hazards models for CHD including age,…
Thyroid Hormones and Timing of Pubertal Onset in a Longitudinal Cohort of Females, Northern California, 2006-11
Pubertal timing is regulated by a complex interplay of hormones. Few studies have evaluated the role of thyroid hormones in pubertal onset. We investigated the associations between blood concentrations of free and total thyroxine (FT4, TT4), free triiodothyronine, and thyroid…
Is heart rate variability associated with frequency and intensity of vasomotor symptoms among healthy perimenopausal and postmenopausal women?
Research has suggested that the autonomic nervous system (ANS) is involved in the experience of vasomotor symptoms (VMS) during menopause. We examined the relationship of VMS intensity and heart rate variability (HRV), a measure of ANS function. Women (n =…
Infectious mononucleosis, other infections and prostate-specific antigen concentration as a marker of prostate involvement during infection.
Although Epstein-Barr virus has been detected in prostate tissue, no associations have been observed with prostate cancer in the few studies conducted to date. One possible reason for these null findings may be use of cumulative exposure measures that do…
CYP24A1 variant modifies the association between use of oestrogen plus progestogen therapy and colorectal cancer risk
Menopausal hormone therapy (MHT) use has been consistently associated with a decreased risk of colorectal cancer (CRC) in women. Our aim was to use a genome-wide gene-environment interaction analysis to identify genetic modifiers of CRC risk associated with use of…
Maternal Leisure Time Physical Activity and Infant Birth Size
BACKGROUND: Associations of maternal leisure time physical activity with birth size are inconsistent. Roles of infant sex and maternal prepregnancy body mass index (BMI) in these associations have not been studied. METHODS: Participants (N = 3,310) in the Omega study,…
Occult Uterine Sarcoma and Leiomyosarcoma: Incidence of and Survival Associated With Morcellation
To estimate the incidence of occult uterine sarcoma and leiomyosarcoma in hysterectomies for leiomyomas and the risk associated with their morcellation. We conducted a population-based cohort study. All uterine sarcomas from 2006-2013 in an integrated health care system were identified.…
Predictors of impact of vaginal symptoms in postmenopausal women
This study aims to identify factors associated with greater impact of vaginal symptoms on the functioning and well-being of postmenopausal women. Postmenopausal women who reported vaginal dryness, itching, irritation, or pain with sexual activity completed the multidimensional Day-to-day Impact of…
Associations of Early and Late Gestational Weight Gain with Infant Birth Size
OBJECTIVES: Associations of gestational weight gain (GWG) during specific periods of pregnancy with infant birth size have been inconsistent. Infant sex-specific differences in these associations are unknown METHODS: Information on GWG (kg) [total, early (
Relationship between self-reported residential indoor remodeling and semen quality: a case-control study
The present study examined the association between residential indoor remodeling and poor semen quality. Sperm donors aged 18-45 years old were recruited in Shanghai, China. Semen specimens were collected and analyzed. An in-person interview was conducted to obtain information on…
Thyroid Hormones and Moderate Exposure to Perchlorate during Pregnancy in Women in Southern California
Findings from national surveys suggest that everyone in the US is exposed to perchlorate. At high doses, perchlorate, thiocyanate, and nitrate inhibit iodide uptake into the thyroid and decrease thyroid hormone production. Small changes in thyroid hormones during pregnancy, including…
Associations between Bisphenol A Exposure and Reproductive Hormones among Female Workers
The associations between Bisphenol-A (BPA) exposure and reproductive hormone levels among women are unclear. A cross-sectional study was conducted among female workers from BPA-exposed and unexposed factories in China. Women's blood samples were collected for assay of follicle-stimulating hormone (FSH),…
Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials
More than two-thirds of US women are overweight or obese, placing them at increased risk for postmenopausal breast cancer. To investigate in this secondary analysis the associations of overweight and obesity with risk of postmenopausal invasive breast cancer after extended…
Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms
To describe the effects of six interventions for menopausal vasomotor symptoms relative to control in a pooled analysis, facilitating translation of the results for clinicians and symptomatic women. The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network tested…
Effects of estrogen and venlafaxine on menopause-related quality of life in healthy postmenopausal women with hot flashes: a placebo-controlled randomized trial
This study aims to evaluate the effects of low-dose estradiol (E2) or venlafaxine on menopause-related quality of life and associated symptoms in healthy perimenopausal and postmenopausal women with hot flashes. A double-blind, placebo-controlled, randomized trial of low-dose oral 17?-E2 0.5…
The Association Between Influenza Vaccination and Other Preventative Health Behaviors in a Cohort of Pregnant Women
Although pregnant women are a high-priority group for seasonal influenza vaccination, vaccination rates in this population remain below target levels. Previous studies have identified sociodemographic predictors of vaccine choice, but relationships between preconception heath behaviors and seasonal influenza vaccination are…
Factors Associated with Seasonal Influenza Vaccination in Pregnant Women
This observational study followed a cohort of pregnant women during the 2010-2011 influenza season to determine factors associated with vaccination. Participants were 1105 pregnant women who completed a survey assessing health beliefs related to vaccination upon enrollment and were then…
Serum 25 Hydroxyvitamin D, Bone Mineral Density and Fracture Risk Across the Menopause
Low levels of serum 25 Hydroxyvitamin D [25(OH)D] have been linked to greater fracture risk in older women. This study aimed to determine whether higher 25(OH)D is associated with slower loss of bone mineral density (BMD) and lower fracture risk…
Reproductive health outcomes of insured adolescent and adult women who access oral levonorgestrel emergency contraception
To assess the level of risk for adolescents and women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes…
Breastfeeding Versus Formula-Feeding and Girls’ Pubertal Development
To examine the association of breastfeeding or its duration with timing of girls' pubertal onset, and the role of BMI as a mediator in these associations. A population of 1,237 socio-economically and ethnically diverse girls, ages 6-8 years, was recruited…
The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women’s Health Initiative
Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this…
Day-to-Day Impact of Vaginal Aging questionnaire: a multidimensional measure of the impact of vaginal symptoms on functioning and well-being in postmenopausal women
This study aims to develop a self-report questionnaire assessing the impact of vaginal dryness, soreness, itching, irritation, and pain on functioning and well-being in postmenopausal women. Structured self-report items were developed to address the impact of vaginal symptoms on functioning…
A STUDY OF GENOTYPING FOR THE MANAGEMENT OF HUMAN PAPILLOMAVIRUS-POSITIVE, CYTOLOGY-NEGATIVE CERVICAL SCREENING RESULTS
The effective management of women with human papillomavirus (HPV)-positive, cytology-negative results is critical to the introduction of HPV testing into cervical screening. HPV typing has been recommended for colposcopy triage, but it is not clear which combinations of high-risk HPV…
Bringing patients’ social context into the examination room: an investigation of the discussion of social influence during contraceptive counseling
Although social networks are an increasingly recognized influence on contraceptive use, little is known about if and how social influences are discussed during women's contraceptive counseling visits. We performed a mixed-methods analysis of audio recordings of contraceptive counseling visits. We…
Genital herpes and its treatment in relation to preterm delivery
To examine the risks of genital herpes and antiherpes treatment during pregnancy in relation to preterm delivery (PTD), we conducted a multicenter, member-based cohort study within 4 Kaiser Permanente regions: northern and southern California, Colorado, and Georgia. The study included…
The Impact of Multimorbidity on Sexual Function in Middle-Aged and Older Women: Beyond the Single Disease Perspective
Little is known about sexual activity and function in women with multiple chronic health conditions. To examine the impact of multimorbidity on sexual activity and function in middle-aged and older women. Multiethnic cross-sectional cohort of 1,997 community-dwelling women (mean age…
Volume and Type of Alcohol During Early Pregnancy and the Risk of Miscarriage
Research on alcohol consumption during pregnancy and miscarriage spans over three decades, yet the relationship is still not well-understood. To assess the relationship between volume and type of alcohol consumed during pregnancy in relation to miscarriage. We utilized data from…
Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women’s Health Initiative
Metabolic, hormonal, and hemostatic changes associated with pregnancy loss (stillbirth and miscarriage) may contribute to the development of cardiovascular disease (CVD) in adulthood. This study evaluated prospectively the association between a history of pregnancy loss and CVD in a cohort…
Low-Dose Estradiol and the Serotonin-Norepinephrine Reuptake Inhibitor Venlafaxine for Vasomotor Symptoms: A Randomized Clinical Trial
Estrogen therapy is the gold standard treatment for hot flashes and night sweats, but some women are unable or unwilling to use it because of associated risks. The serotonin-norepinephrine reuptake inhibitor venlafaxine hydrochloride is used widely as a nonhormonal treatment.…
Efficacy of exercise for menopausal symptoms: a randomized controlled trial
This study aims to determine the efficacy of exercise training for alleviating vasomotor and other menopausal symptoms. Late perimenopausal and postmenopausal sedentary women with frequent vasomotor symptoms (VMS) participated in a randomized controlled trial conducted in three sites: 106 women…
Gestational weight gain and neonatal adiposity in the Hyperglycemia and Adverse Pregnancy Outcome study-North American region
OBJECTIVE: To examine the associations between gestational weight gain (GWG) exceeding Institute of Medicine (IOM) guidelines and neonatal adiposity in the five North American field centers of the Hyperglycemia and Adverse Pregnancy Outcome study.METHODS: GWG was categorized as less than,…
Menopausal Quality of Life: A RCT of Yoga, Exercise and Omega-3 Supplements
The purpose of this study was to determine the efficacy of 3 nonhormonal therapies for the improvement of menopause-related quality of life in women with vasomotor symptoms. We conducted a 12-week 3 × 2 randomized, controlled, factorial design trial. Peri-…
Effectiveness of seasonal trivalent influenza vaccine for preventing influenza virus illness among pregnant women: a population-based case-control study during the 2010-2011 and 2011-2012 influenza seasons
Although vaccination with trivalent inactivated influenza vaccine (TIV) is recommended for all pregnant women, no vaccine effectiveness (VE) studies of TIV in pregnant women have assessed laboratory-confirmed influenza outcomes. We conducted a case-control study over 2 influenza seasons (2010-2011 and…
Ovarian cancer rates after hysterectomy with and without salpingo-oophorectomy
To estimate ovarian and peritoneal cancer rates after hysterectomy with and without salpingo-oophorectomy for benign conditions. All patients after hysterectomy for benign disease from 1988 to 2006 in Kaiser Permanente Northern California, an integrated health organization. Incidence rates per 100,000…
Feasibility and acceptability of a novel, computerized screening and brief intervention (SBI) for alcohol and sweetened beverage use in pregnancy
Recommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings. We evaluated the feasibility, acceptability and validity of a new self-administered, single-session, bilingual, computerized Screening and…
Prepregnancy SHBG Concentrations and Risk for Subsequently Developing Gestational Diabetes Mellitus
Lower levels of sex hormone-binding globulin (SHBG) have been associated with increased risk of diabetes among postmenopausal women; however, it is unclear whether they are associated with glucose intolerance in younger women. We examined whether SHBG concentrations, measured before pregnancy,…
LINE-1 hypomethylation in spermatozoa is associated with Bisphenol A exposure
Bisphenol A (BPA) is an endocrine disruptor with potentially harmful effects on humans. However, epigenetic mechanisms that modulate the effects of BPA remain unclear. Methylation of long interspersed nucleotide elements (LINE-1) is a marker of genome-wide methylation status. This study…
Methods for the design of vasomotor symptom trials: the Menopausal Strategies: Finding Lasting Answers to Symptoms and Health network
This report describes the Menopausal Strategies: Finding Lasting Answers to Symptoms and Health network and methodological issues addressed in designing and implementing vasomotor symptom trials. Established in response to a National Institutes of Health request for applications, the network was…
Onset of Breast Development in a Longitudinal Cohort
There is growing evidence of pubertal maturation occurring at earlier ages, with many studies based on cross-sectional observations. This study examined age at onset of breast development (thelarche), and the impact of BMI and race/ethnicity, in the 3 puberty study…
Counseling and provision of long-acting reversible contraception in the US: National survey of nurse practitioners
Nurse practitioners (NPs) provide frontline care in women's health, including contraception, an essential preventive service. Their importance for contraceptive care will grow, with healthcare reforms focused on affordable primary care. This study assessed practice and training needs to prepare NPs…
Childbirth and female sexual function later in life
To examine relationships among parity, mode of delivery, and other parturition-related factors with women's sexual function later in life. Self-administered questionnaires examined sexual desire, activity, satisfaction, and problems in a multiethnic cohort of women aged 40 years and older with…
African American race but not genome-wide ancestry is negatively associated with atrial fibrillation among postmenopausal women in the Women’s Health Initiative
Atrial fibrillation (AF) is the most common arrhythmia in women and is associated with higher rates of stroke and death. Rates of AF are lower in African American subjects compared with European Americans, suggesting European ancestry could contribute to AF…
Evaluation of e-mail contact to conduct follow-up among adolescent women participating in a longitudinal cohort study of contraceptive use
The purpose of this study was to determine whether e-mail contact is a viable method for gathering information from adolescent women about contraceptive use. Adolescent women initiating contraception followed in a prospective longitudinal cohort study and who had access to…
Oral Contraceptive Use and the ECG: Evidence of an Adverse QT Effect on Corrected QT Interval
A prolonged corrected QT (QTc) interval is a marker for an increased risk of sudden cardiac death. We evaluated the relationship between oral contraceptive (OC) use, type of OC, and QTc interval. We identified 410,782 ECGs performed at Northern California…
Pregnancy Glycemia in Mexican-American Women Without Diabetes or Gestational Diabetes and Programming for Childhood Obesity
In the present study, we estimated the association between pregnancy glucose levels and offspring body mass index (BMI) z scores at 2, 3.5, 5, and 7 years of age, as well as z score trajectories across this age range, among…
Prevalence and trends in the use of antipsychotic medications during pregnancy in the U.S., 2001-2007: a population-based study of 585,615 deliveries
This study aims to estimate the prevalence of and temporal trends in prenatal antipsychotic medication use within a cohort of pregnant women in the U.S. We identified live born deliveries to women aged 15-45 years in 2001-2007 from 11 U.S.…
Five-year risk of recurrence after treatment of CIN 2, CIN 3, or AIS: performance of HPV and Pap cotesting in posttreatment management
After excisional treatment, cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) can recur. It is not clear how many negative posttreatment Pap or cotest results are needed to ensure adequate safety against CIN 2+ before returning to extended retesting…
Five-year risk of CIN 3+ to guide the management of women aged 21 to 24 years
Current US national guidelines recommend beginning screening at age 21 using Pap tests only, with cotesting starting at age 30. To inform the management of Pap test abnormalities among women aged 21 to 24 years, who have extremely low cancer…
Five-year risks of CIN 3+ and cervical cancer among women with HPV testing of ASC-US Pap results
New screening guidelines recommend that human papillomavirus (HPV)-negative/atypical squamous cells of undetermined significance (ASC-US) results be considered as equivalent to HPV-negative/Pap-negative results, leading to rescreening in 5 years. However, despite ample data, the routine clinical performance of HPV testing of…
Benchmarking CIN 3+ risk as the basis for incorporating HPV and Pap cotesting into cervical screening and management guidelines
In 2012, the US Preventive Services Task Force (USPSTF) and a consensus of 25 organizations endorsed concurrent cytology and human papillomavirus (HPV) testing ("cotesting") for cervical cancer screening. Past screening and management guidelines were implicitly based on risks defined by…
Invasive cervical cancer risk among HIV-infected women: A North American multi-cohort collaboration prospective study
OBJECTIVE: HIV infection and low CD4+ T-cell count are associated with an increased risk of persistent oncogenic human papillomavirus infection-the major risk factor for cervical cancer. Few reported prospective cohort studies have characterized the incidence of invasive cervical cancer (ICC)…
Five-year risks of CIN 2+ and CIN 3+ among women with HPV-positive and HPV-negative LSIL Pap results
Low-grade squamous intraepithelial lesion (LSIL) Pap results do not typically lead to human papillomavirus (HPV) testing. HPV triage is not cost-effective because most cases are HPV-positive. However, under new national guidelines recommending cotesting for women aged 30 to 64 years,…
Recent combined hormonal contraceptives (CHCs) and the risk of thromboembolism and other cardiovascular events in new users
BACKGROUND: Combined hormonal contraceptives (CHCs) place women at increased risk of venous thromboembolic events (VTEs) and arterial thrombotic events (ATEs), including acute myocardial infarction and ischemic stroke. There is concern that three recent CHC preparations [drospirenone-containing pills (DRSPs), the norelgestromin-containing…
Prevalence, Trends, and Patterns of Use of Antidiabetic Medications Among Pregnant Women, 2001-2007
OBJECTIVE:: To describe the prevalence, trends, and patterns in use of antidiabetic medications to treat hyperglycemia and insulin resistance before and during pregnancy in a large U.S. cohort of insured pregnant women. METHODS:: Pregnancies resulting in live births were identified…
With pills, patches, rings, and shots: who still uses condoms? A longitudinal cohort study
PURPOSE: To describe women's condom use patterns over time and assess predictors of dual method use 12 months after initiating hormonal contraceptives. METHODS: We conducted a prospective cohort study among women aged 15-24 years initiating oral contraceptive pills, patch, ring,…
Accelerated Cell Aging in Female APOE-epsilon4 Carriers: Implications for Hormone Therapy Use
Apolipoprotein-epsilon4 (APOE-epsilon4) is a major genetic risk factor for cognitive decline, Alzheimer's disease (AD) and early mortality. An accelerated rate of biological aging could contribute to this increased risk. Here, we determined whether APOE-epsilon4 status impacts leukocyte telomere length (TL)…
Neisseria gonorrhea and Chlamydia trachomatis Screening at Intrauterine Device Insertion and Pelvic Inflammatory Disease
OBJECTIVE: To evaluate the relationship between Neisseria gonorrhea and Chlamydia trachomatis screening strategies and risk of pelvic inflammatory disease (PID) after intrauterine device (IUD) insertion. METHODS: We conducted a retrospective cohort study of all IUD insertions at Kaiser Permanente Northern…
A low-fat dietary pattern and risk of metabolic syndrome in postmenopausal women: The Women’s Health Initiative
OBJECTIVE: Nutrition plays an important role in metabolic syndrome etiology. We examined whether the Women's Health Initiative (WHI) Dietary Modification Trial influenced metabolic syndrome risk. MATERIALS/METHODS: 48,835 postmenopausal women aged 50-79 years were randomized to a low-fat (20% energy from…
Bone resorption and fracture across the menopausal transition: the Study of Women’s Health Across the Nation
OBJECTIVE: Bone turnover markers (BTMs) predict fracture in older women, whereas data on younger women are lacking. To test the hypothesis that BTMs measured before and after menopause predict fracture risk, we performed a cohort study of 2,305 women. METHODS:…
Alcohol, tobacco and drug use as reasons for abortion
AIMS: Concern about the effects of alcohol and drug use during pregnancy is intertwined with debates about abortion. There is concern that alcohol abstinence recommendations lead women using low levels of alcohol to terminate otherwise wanted pregnancies. This study examines…
Ethnic variability in bone geometry as assessed by hip structure analysis: Findings from the hip strength across the menopausal transition study
Racial/ethnic origin plays an important role in fracture risk. Racial/ethnic differences in fracture rates cannot be fully explained by bone mineral density (BMD). Studies examining the influence of bone geometry and strength on fracture risk have focused primarily on older…
Vasomotor Symptoms and Insulin Resistance in the Study of Women’s Health Across the Nation
CONTEXT: Emerging research suggests links between menopausal hot flashes and cardiovascular disease risk. The mechanisms underlying these associations are unclear, due to the incomplete understanding of the physiology of hot flashes. OBJECTIVE AND MAIN OUTCOME MEASURES: We examined the associations…
Fecal Incontinence Decreases Sexual Quality of Life, But Does Not Prevent Sexual Activity in Women
BACKGROUND: The impact of anal incontinence on women's sexual function is poorly understood. OBJECTIVE: The aim of this study was to investigate the relationship between anal incontinence and sexual activity and functioning in women. DESIGN: This is a cross-sectional study.…
Risk of preterm delivery in non-diabetic women with polycystic ovarian syndrome
OBJECTIVE: To examine the risk and etiology of preterm delivery in women with polycystic ovary syndrome (PCOS). STUDY DESIGN: Retrospective cohort study comparing preterm delivery rate among non-diabetic PCOS and non-PCOS women with singleton pregnancy. Multivariable logistic regression was used…
Do Changes in Sex Steroid Hormones Precede or Follow Increases in Body Weight during the Menopause Transition? Results from The Study of Women’s Health Across the Nation
CONTEXT: Whether menopause-related changes in sex steroids account for midlife weight gain in women or whether weight drives changes in sex steroids remains unanswered. OBJECTIVE: The objective of the study was to characterize the potential reciprocal nature of the associations…
Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative
OBJECTIVE: The aim of this study was to determine whether a dietary intervention designed to reduce fat intake and increase intake of fruit, vegetables, and whole grains, and weight loss, reduces vasomotor symptoms (VMS; ie, hot flashes or night sweats)…
Prevalence of cervical insufficiency in polycystic ovarian syndrome
BACKGROUND: Pregnant women with polycystic ovarian syndrome (PCOS) experience a greater rate of adverse obstetrical outcomes compared with non-PCOS women. We examined the prevalence and incidence of cervical insufficiency (CI) in a community cohort of pregnant women with and without…
Sex Hormones and the QT Interval: A Review
A prolonged QT interval is a marker for an increased risk of ventricular tachyarrhythmias. Both endogenous and exogenous sex hormones have been shown to affect the QT interval. Endogenous testosterone and progesterone shorten the action potential, and estrogen lengthens the…
Psychological stress and reproductive aging among pre-menopausal women
BACKGROUND: Life history models suggest that biological preparation for current versus longer term reproduction is favored in environments of adversity. In this context, we present a model of reproductive aging in which environmental adversity is proposed to increase the number…
Effect of escitalopram on insomnia symptoms and subjective sleep quality in healthy perimenopausal and postmenopausal women with hot flashes: a randomized controlled trial
OBJECTIVE: The aim of this study was to determine the effect of escitalopram on insomnia symptoms and subjective sleep quality in healthy perimenopausal and postmenopausal women with hot flashes. METHODS: A randomized, blinded, multicenter, placebo-controlled parallel-group 8-week trial with 205…
Diabetes mellitus and sexual function in middle-aged and older women
Diabetes mellitus is an established risk factor for sexual dysfunction in men, but its effect on female sexual function is poorly understood. We examined the relationship of diabetes to sexual function in middle-aged and older women. Sexual function was examined…
Population-based study of erectile dysfunction and polypharmacy
Study Type - Symptom prevalence (population cohort). Level of Evidence 1b. What's known on the subject? and What does the study add? It is known that medical conditions such as diabetes, high blood pressure, high cholesterol, smoking and prescribed medications…
Prepregnancy cardiometabolic and inflammatory risk factors and subsequent risk of hypertensive disorders of pregnancy
OBJECTIVE: The purpose of this study was to examine prepregnancy cardiometabolic and inflammatory markers and the subsequent risk of hypertensive disorders of pregnancy. STUDY DESIGN: This was a retrospective cohort study of 3380 women who took part in a comprehensive…
Racial/Ethnic Disparities in the Prevalence of Gestational Diabetes by BMI
OBJECTIVE: To examine whether the association between gestational diabetes mellitus (GDM) and BMI category varies by racial/ethnic group. RESEARCH DESIGN AND METHODS: In a cohort of 123,040 women without recognized pregravid diabetes who delivered babies between 1995 and 2006 at…
Racial and ethnic differences in the prevalence of placenta previa
OBJECTIVE: The objective of this study is to determine the prevalence of placenta previa among different racial and ethnic groups. STUDY DESIGN: We conducted a retrospective cohort study to examine the prevalence of placenta previa among five major racial and…
A systematic review to calculate background miscarriage rates using life table analysis
The objectives of the current study were to calculate: (1) the expected rates of miscarriage by gestational week; (2) the cumulative risk of miscarriage; and (3) the remaining risk of miscarriage for gestational weeks five through 20, through a systematic…
Laboratory and ambulatory evaluation of vasomotor symptom monitors from the Menopause Strategies Finding Lasting Answers for Symptoms and Health network
OBJECTIVE: The aim of this study was to evaluate monitors for assessing vasomotor symptoms (VMS) in laboratory and ambulatory settings before use in the Menopause Strategies Finding Lasting Answers for Symptoms and Health network clinical trials testing VMS therapies. METHODS:…
Effect of Postdiagnosis Weight Change on Hot Flash Status Among Early-Stage Breast Cancer Survivors
PURPOSE: Hot flashes (HF) affect a large proportion of breast cancer (BC) survivors and can negatively affect their quality of life. Treatments other than estrogen replacement to alleviate HF are needed. Body weight is related to hot flashes, but little…
Vasomotor Symptoms and Lipid Profiles in Women Transitioning Through Menopause
OBJECTIVE: To examine associations between vasomotor symptoms and lipids over 8 years, controlling for other cardiovascular risk factors, estradiol, and follicle-stimulating hormone. METHODS: Study of Women's Health Across the Nation participants (N=3,201), aged 42-52 years at entry, completed interviews on…
An Over-the-Counter Simulation Study of a Single-Tablet Emergency Contraceptive in Young Females
OBJECTIVES: To evaluate use of a single-tablet (levonorgestrel 1.5 mg) emergency contraceptive administered to young females under simulated over-the-counter conditions. Secondary objectives were to assess repeat use, pregnancy, and adverse events. METHODS: Females aged 11-17 years requesting emergency contraception at…
Pregnancy during adolescence has lasting adverse effects on blood lipids: A 10-year longitudinal study of black and white females
BACKGROUND: Primiparity has been associated with 3 to 4 mg/dL lower high-density lipoprotein cholesterol concentrations in black and white adult women that persist several years after delivery. OBJECTIVE: To examine the lasting effects of adolescent pregnancy on blood lipids, an…
Provision of Contraceptive Services to Women with Diabetes Mellitus
BACKGROUND: Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes. OBJECTIVE: To compare rates of provision of contraceptive services among women with diabetes mellitus and women without chronic medical conditions.…
Genetic variants and environmental factors associated with hormonal markers of ovarian reserve in Caucasian and African American women
BACKGROUND: The ovarian reserve (number and quality of oocytes) is correlated with reproductive potential as well as somatic health, and is likely to have multiple genetic and environmental determinants. Several reproductive hormones are closely linked with the oocyte pool and…
A characterization of the relationship of ovarian reserve markers with age
OBJECTIVE: To identify markers of ovarian age that best match the pattern of oocyte loss seen in histology specimens. DESIGN: Cross-sectional study. SETTING: University. PATIENT(S): Caucasian women (n = 252) aged 25-45 years. INTERVENTION(S): none. MAIN OUTCOME MEASURE(S): The relationship…
The impact of the iPLEDGE program on isotretinoin fetal exposure in an integrated health care system
BACKGROUND: Preventing fetal exposure to isotretinoin is widely acknowledged as an important safety issue. The iPLEDGE program is the latest in a series of Food and Drug Administration-mandated risk management programs designed to prevent pregnancies in female patients of childbearing…
Reproductive and menstrual factors and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women
PURPOSE: The contribution of menstrual and reproductive factors to risk of ductal carcinoma (DCIS) of the breast is poorly understood. METHODS: The association between menstrual and reproductive factors and subsequent DCIS risk was examined in Women's Health Initiative (WHI) clinical…
Are vasomotor symptoms associated with alterations in hemostatic and inflammatory markers? Findings from the Study of Women’s Health Across the Nation
OBJECTIVE: Emerging research suggests links between menopausal hot flashes and cardiovascular risk. The mechanisms underlying these associations are unclear due, in part, to the incomplete understanding of the physiology of hot flashes. We aimed to examine the longitudinal associations between…
Bone and the perimenopause
Loss of ovarian function has a profound impact on female skeletal health. Bone mineral density findings from the Study of Women's Health Across the Nation demonstrate an accelerated rate of bone loss during the menopausal transition. The greatest reduction occurs…
Physical activity and health during the menopausal transition
The benefits of regular physical activity are well established, but evidence for a protective effect against the adverse health consequences accompanying the menopausal transition is limited. This article reviews that evidence, concluding that more physical activity is generally associated with…
Population-based ectopic pregnancy trends, 1993-2007
BACKGROUND: The accuracy of ectopic pregnancy rates based on nationally representative data has been compromised for many years, impairing surveillance and evaluation of the continued public health importance of this condition. PURPOSE: To estimate long-term population-based ectopic pregnancy rates and…
Father absence, body mass index, and pubertal timing in girls: differential effects by family income and ethnicity
PURPOSE: Numerous studies show associations between father absence and girls' early puberty. However, most research has been retrospective, focused on menarche, and failed to consider body mass index (BMI), ethnicity, and income in the analyses. This study resolves these scientific…
Regular nonsteroidal anti-inflammatory drug use and erectile dysfunction
PURPOSE: Previous data suggest a potential relationship between inflammation and erectile dysfunction. If it is causal, nonsteroidal anti-inflammatory drug use should be inversely associated with erectile dysfunction. To this end we examined the association between nonsteroidal anti-inflammatory drug use and…
Polychlorinated biphenyl (PCB) exposure in mothers and time to pregnancy in daughters
Developmental exposure to polychlorinated biphenyls (PCBs) disrupts reproduction in animals. Human data are lacking. We measured PCBs in preserved mothers' serum samples collected during 1960-1963, 1-3 days after their daughters' birth. We recorded time to pregnancy (TTP) in 289 daughters…
Vitamin D, pregnancy, breastfeeding, and postpartum multiple sclerosis relapses
OBJECTIVE: To determine whether low levels of 25-hydroxyvitamin D (25[OH]D) contribute to the increased risk of postpartum multiple sclerosis (MS) relapses. DESIGN: Prospective cohort study. SETTING: Outpatients identified through membership records of Kaiser Permanente Northern California or Stanford University outpatient…
Socioeconomic status and polycystic ovary syndrome
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common metabolic-endocrine disorder in women and is associated with a number of metabolic morbidities. We examined the association of PCOS and its components with socioeconomic status (SES) over the life course to explore…
Strategies for diabetes prevention before and after pregnancy in women with GDM
Interventions for lifestyle modification promoting weight loss and pharmacotherapy interventions for improving insulin sensitivity have been shown to be effective in preventing or delaying the onset of type 2 diabetes (T2DM) in high risk populations. Women with gestational diabetes mellitus…
Adverse childhood experiences and repeat induced abortion
OBJECTIVE: The objective of the study was to characterize the backgrounds of women who have repeat abortions. STUDY DESIGN: In a cross-sectional study of 259 women (mean age, 35.2 +/- 5.6 years), the relation between adverse experiences in childhood and…
Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial
CONTEXT: Concerns regarding the risks associated with estrogen and progesterone to manage menopausal symptoms have resulted in its declining use and increased interest in nonhormonal treatments with demonstrated efficacy for hot flashes. OBJECTIVE: To determine the efficacy and tolerability of…
Timing of hormone therapy and dementia: the critical window theory revisited
OBJECTIVE: Although previous research has shown that initiation of postmenopausal estrogen hormone therapy (HT) in late life increases risk of dementia, animal studies and some observational studies have suggested that midlife use of HT may be beneficial; however, this has…
Polycystic ovary syndrome and risk for long-term diabetes and dyslipidemia
To estimate whether women aged 20-32 years who fulfilled National Institutes of Health criteria for polycystic ovary syndrome (PCOS) would be at higher risk for subsequent development of incident diabetes, dyslipidemia, and hypertension, and to estimate whether normal-weight women with…
Pre-pregnancy stress reactivity and pregnancy outcome
Stress has been proposed as a cause of preterm birth (PTB) and small-for-gestational age (SGA), but stress does not have the same effects on all women. It may be that a woman's reaction to stress relates to her pregnancy health,…
The polycystic ovary post-rotterdam: a common, age-dependent finding in ovulatory women without metabolic significance
INTRODUCTION: The age-specific prevalence of polycystic ovaries (PCO), as defined by the Rotterdam criteria, among normal ovulatory women, has not yet been reported. It is also uncertain whether these women differ from their peers in the hormonal or metabolic profile.…
Antral follicle count: absence of significant midlife decline
OBJECTIVE: To examine the conventional wisdom that declines in antral follicle count accelerate after approximately 37 years of age, which has influenced clinical decision making. We critically examine evidence for this sudden acceleration. DESIGN: Cross-sectional study. SETTING: Academic setting. PATIENT(S):…
Incidence of and risk factors for change in urinary incontinence status in a prospective cohort of middle-aged and older women: the reproductive risk of incontinence study in Kaiser
PURPOSE: Urinary incontinence is a dynamic condition that can progress and regress but few groups have examined risk factors for change in incontinence status. MATERIAL AND METHODS: We used stratified random sampling to construct a racially and ethnically diverse, population…
Pubertal assessment method and baseline characteristics in a mixed longitudinal study of girls
OBJECTIVES: The objective of this study was to describe the assessment methods and maturation status for a multisite cohort of girls at baseline recruitment and at ages 7 and 8 years. METHODS: The method for pubertal maturation staging was developed…
Urinary incontinence, fecal incontinence and pelvic organ prolapse in a population-based, racially diverse cohort: prevalence and risk factors
OBJECTIVES: : We investigated the prevalence of and risk factors for combinations of urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) in racially diverse women older than 40 years. METHODS: : The Reproductive Risks for Incontinence Study…
Increased risk of high-grade prostate cancer among infertile men
BACKGROUND: It has been reported that fatherhood status may be a risk factor for prostate cancer. In the current study, the authors examined the subsequent occurrence of prostate cancer in a cohort of men evaluated for infertility to determine whether…
Association of adolescent obesity and lifetime nulliparity–the Study of Women’s Health Across the Nation (SWAN)
OBJECTIVE: To evaluate whether adolescent obesity is associated with difficulties in becoming pregnant later in life. DESIGN: Cross-sectional analysis of baseline data from a longitudinal cohort. SETTING: Multiethnic, community-based observational study of U.S. women. PATIENT(S): Three thousand one hundred fifty-four…
Pregnancy outcomes by pregnancy intention in a managed care setting
OBJECTIVES: Published studies show poor pregnancy outcomes associated with unintended pregnancies are disproportionately higher than in planned pregnancies and place a burden on the health care system. This study was designed to compare pregnancy intention rates, compare sociodemographic characteristics of…
Interferon-gamma-producing T cells, pregnancy, and postpartum relapses of multiple sclerosis
OBJECTIVE: To determine whether fluctuations in functional T-cell subsets can explain why multiple sclerosis (MS) relapses decline during pregnancy and increase in the postpartum period. DESIGN: Case-control study. SETTING: Kaiser Permanente Northern California and Stanford University. PARTICIPANTS: Twenty-six pregnant women…
Exposure to magnetic fields and the risk of poor sperm quality
We conducted a population-based case-control study among healthy sperm donors to study exposure to magnetic fields (MFs) and poor sperm quality. All participants wore a meter to capture daily MF exposure. After controlling for confounders, compared to those with lower…
Racial differences in pelvic organ prolapse
OBJECTIVE: To compare the estimated prevalence of, risk factors for, and level of bother associated with subjectively reported and objectively measured pelvic organ prolapse in a racially diverse cohort. METHODS: The Reproductive Risks for Incontinence Study at Kaiser 2 is…
Racial disparities in erectile dysfunction among participants in the California Men’s Health Study
INTRODUCTION: The burden of erectile dysfunction (ED) among different racial and ethnic groups is unclear, in part, because prior studies have not included all four major racial and ethnic groups in the same population-based sample. AIM: To determine the prevalence…
Association between menopausal transition stages and developing urinary incontinence
OBJECTIVE: To estimate whether menopause transition stage is independently associated with the development of incontinence symptoms. METHODS: We conducted a longitudinal analysis, using discrete proportional hazards models, of women who were continent at baseline in the Study of Women's Health…
Gains in body fat and vasomotor symptom reporting over the menopausal transition: the study of women’s health across the nation
Although most women report vasomotor symptoms (hot flashes, night sweats) during midlife, their etiology and risk factors are incompletely understood. Body fat is positively associated with vasomotor symptoms cross-sectionally, but the longitudinal relation between changes in body fat and vasomotor…
Childbearing is associated with higher incidence of the metabolic syndrome among women of reproductive age controlling for measurements before pregnancy: the CARDIA study
OBJECTIVE: We sought to prospectively examine whether childbearing is associated with higher incidence of the metabolic syndrome (MetS) after delivery among women of reproductive age. STUDY DESIGN: In 1451 nulliparas who were aged 18-30 years and free of the MetS…
Sexual function and aging in racially and ethnically diverse women
OBJECTIVES: To examine factors influencing sexual activity and functioning in racially and ethnically diverse middle-aged and older women. DESIGN: Cross-sectional cohort study. SETTING: Integrated healthcare delivery system. PARTICIPANTS: One thousand nine hundred seventy-seven women aged 45 to 80. MEASUREMENTS: Self-administered…
Maternal diet and risk of childhood acute lymphoblastic leukemia
OBJECTIVE: Intrauterine environmental factors, including maternal diet, may play an etiologic role in acute lymphoblastic leukemia (ALL), a common childhood cancer. Expanding on previous findings from phase 1 of the Northern California Childhood Leukemia Study (NCCLS), a population-based case-control study,…
Childbearing and obesity in women: weight before, during, and after pregnancy
Weight gain and the development of obesity during midlife are strong independent predictors of cardiovascular disease, particularly among women, as well as the metabolic syndrome, type 2 diabetes, and early mortality. Primiparity and maternal body size before pregnancy affect long-term…
Lipid changes during the menopause transition in relation to age and weight: the Study of Women’s Health Across the Nation
Few studies have prospectively examined lipid changes across the menopause transition or in relation to menopausal changes in endogenous hormones. The relative independent contributions of menopause and age to lipid changes are unclear. Lipid changes were examined in relation to…
Dietary change and reduced breast cancer events among women without hot flashes after treatment of early-stage breast cancer: subgroup analysis of the Women’s Healthy Eating and Living Study
BACKGROUND: A diet high in vegetables, fruit, and fiber and low in fat decreased additional risk of secondary breast cancer events in women without hot flashes (HF-) compared with that in women with hot flashes (HF+), possibly through lowered concentrations…
Biomarker-calibrated energy and protein consumption and increased cancer risk among postmenopausal women
The authors previously reported equations, derived from the Nutrient Biomarker Study within the Women's Health Initiative, that produce calibrated estimates of energy, protein, and percentage of energy from protein consumption from corresponding food frequency questionnaire estimates and data on other…
Black-White differences in hysterectomy prevalence: the CARDIA study
OBJECTIVES: We evaluated the cross-sectional association between race and hysterectomy prevalence in a population-based cohort of US women and investigated participant characteristics associated with racial differences. METHODS: The cohort consisted of 1863 Black and White women in the Coronary Artery…
Differences in reproductive risk factors for breast cancer in middle-aged women in Marin County, California and a sociodemographically similar area of Northern California
BACKGROUND: The Northern California county of Marin (MC) has historically had high breast cancer incidence rates. Because of MC's high socioeconomic status (SES) and racial homogeneity (non-Hispanic White), it has been difficult to assess whether these elevated rates result from…
Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: the CARDIA Women’s Study
OBJECTIVE: To determine racial differences in self-reported infertility and in risk factors for infertility in a cohort of black and white women. DESIGN: A cross-sectional analysis of data from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study,…
Menstrual and reproductive factors in relation to mammographic density: the Study of Women’s Health Across the Nation (SWAN)
Menstrual and reproductive factors may increase breast cancer risk through a pathway that includes increased mammographic density. We assessed whether known or suspected menstrual and reproductive breast cancer risk factors were cross-sectionally associated with mammographic density, by measuring area of…
Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard
OBJECTIVE: To evaluate the impact of Early Start, an obstetric clinic-based prenatal substance abuse treatment program, on perinatal outcomes. STUDY DESIGN: Subjects were 49 985 women who completed Prenatal Substance Abuse Screening Questionnaires at obstetric clinics between 1 January 1999…
Factors associated with worsening and improving urinary incontinence across the menopausal transition
OBJECTIVE: To evaluate whether the menopausal transition is associated with worsening of urinary incontinence symptoms over 6 years in midlife women. METHODS: We analyzed data from 2,415 women who reported monthly or more incontinence in self-administered questionnaires at baseline and…
Physical activity and mammographic density in a cohort of midlife women
PURPOSE: Physical activity (PA) is one of few modifiable breast cancer risk factors. There have been few studies of the relation between PA and mammographic density, especially in multiethnic populations. METHODS: In a cohort of pre- and early perimenopausal women…
Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum
Shorter sleep duration is linked to obesity, coronary artery disease, and diabetes. Whether sleep deprivation during the postpartum period affects maternal postpartum weight retention remains unknown. This study examined the association of sleep at 6 months postpartum with substantial postpartum…
Adiposity and reporting of vasomotor symptoms among midlife women: the study of women’s health across the nation
It has long been hypothesized that increased adiposity would be associated with decreased vasomotor symptoms during menopause because of conversion of androgens to estrogens in body fat. However, recent thermoregulatory models have postulated that increased adipose tissue would be associated…
Use of complementary and alternative medicine during the menopause transition: longitudinal results from the Study of Women’s Health Across the Nation
OBJECTIVE: This study examined whether use of complementary and alternative (CAM) therapies during the menopause transition varied by ethnicity. DESIGN: The Study of Women's Health Across the Nation is a prospective cohort study following a group of 3,302 women from…