Natural fertility in northeastern Mexico: genetic structure by year of birth and birthplace

BACKGROUND: The aims of this population genetics study were 1) to ascertain whether 417 Mexican women with natural fertility (45 years of age, married, not using any family planning methods, residing in the state of Nuevo León) were genetically homogeneous, and 2) to compare the genetic structure of this selected population with the previously reported data of random populations of northeastern Mexico. METHODS: A sample of 417 women was interviewed and selected in seven medical units of the Mexican Social Security Institute. They were grouped by their year of birth (1896-1925 and 1926-1955) and birthplace [persons whose four grandparents were born in the northeastern states (NE) and outside the northeastern states (Not-NE) of Mexico]. Eight genetic marker systems were analyzed. RESULTS: Gene diversity analysis suggests that more than 99.1% of the total gene diversity can be attributed to variation between individuals within the population. Genetic admixture analysis suggests that this selected population, stratified by year of birth and birthplace, have received a predominantly Spanish contribution followed by a lesser Mexican Indian contribution. CONCLUSIONS: The genetic structure of this selected population was homogeneous and similar to the random populations of northeastern Mexico. This finding corroborates the utility of this selected population for genetic and epidemiological studies.     

Programme building operation for promotion of family planning: the Indian Statistical Institute clinic experiment

A pilot family planning project from September 1962-1965 at the Indian Statistical Institute created 2 clinics (male and female) as centers of an extension approach which stressed education and aimed at increasing knowledge and group acceptance of family planning and at facilitating availability of supplies and service with medical advice. A total of 90 women and 545 men enrolled in the program; only 215 men accepted supplies regularly (including condoms, foam tablets, jelly, and diaphragm). Of male attenders, data on socioeconomic characteristics indicated that middle class workers (Rs. 101-300/month) were the main acceptors of family planning services. Male clinic goers were concentrated in the 30-39 age group while their wives were mainly 20-29 years. About half of male acceptors and one-third of wives had completed school education. The majority (73.1%) of couples had 0-3 children, but 61.7% of wives were 20-29 years and had not completed their reproductive span. About 58.4% of couples had knowledge of family planning but only 57.9% (of the total) in this group practiced it; the most popular contraceptive method was the condom, accepted by 78.5% of couples. Coital frequency per week varied inversely with: the duration of marriage, number of children, age of spouses, level of husband's education, occupational group and monthly income per couple. Of female clinic visitors, practice and knowledge of family planning were positively correlated with education. The clinics were considered inadequate as main outlets for contraceptive supplies; the female clinic closed in 1964 due to lack of interest. Crude birth rates increased during the first year of the program from 157.7 births per 1000 couples in 1961-62 to 165.1 in 1962-63, and declined in the second year to 152.5.     

湖北省土家族育龄妇女婚姻生育状况调查

目的 :了解湖北省土家族育龄妇女的婚姻、生育状况。方法 :采用分层整群抽样抽取 5 0 2 2户 ,用统一的调查表入户调查育龄妇女 5 70 2人。结果 :1994年湖北省土家族育龄妇女的在婚 (初婚和再婚 )比为 79.6 6 % ,离婚分居比、未婚比、丧偶比分别为 0 .34%、19.17%和 0 .83%。 2 0岁以下育龄妇女的已婚比为 3.49% (宣恩、咸丰、来凤3县分别为 2 .79%、3 .2 1%和 4.5 5 % ) ,30岁及 30岁以上育龄妇女已婚比为 99.5 8%。土家族育龄妇女不同年代的平均初婚年龄有逐渐增大的趋势 ,其中 1993年 1月～ 1994年 7月育龄妇女平均初婚年龄为 2 2 .2 5岁。 1993年 8月～ 1994年 7月土家族育龄妇女的普通生育率为 8.84% ,标化生育率为 8.12 % ,总和生育率为 2 .2 2 %。来凤县标化生育率 (9.77% )高于宣恩 (7.44 % )和咸丰 (7.2 6 % ) (P <0 .0 5和P <0 .0 1)。 2 0岁以下育龄妇女的生育率为 1.36 % ,其中 ,来凤县达 2 .86 %。活产婴儿中 ,一孩比为 5 3.6 8% ,二孩及多孩比分别为 41.35 %和 4.97% ,来凤县多孩比(11.2 3% )高于宣恩 (1.95 % )和咸丰 (0 .6 2 % ) (P <0 .0 1) ,活产婴儿性别比 (男∶女 )为 12 8.1∶10 0。结论 :湖北省土家族育龄妇女婚姻较稳定 ,平均初婚年龄逐年推迟 ,生育率仍处于较高水平 ,某些地区存     

Prevalence and determinants of unmet need for family planning in a district of eastern region of Nepal.

Objectives: The unmet need for family planning is defined as the discrepancy between individual's contraceptive behaviors and their stated fertility preferences - The extent of which is very high in developing countries like Nepal. This study explores the unmet need and its determinants. Methods: Among the teaching district of B.P. Koirala institute of Health Sciences, in the Eastern Region of Nepal, a district was selected randomly to conduct a cross-sectional study. A total of 1079 women were selected using systematic random sampling. We compared different demographic variables and sex-ration to unmet need by using means, percentage and applied chi-squared test where applicable. Result: The extent of unmet need is 25 percent with 9.5 percent for spacing and 15.5 percent for limiting. The mean age at marriage is 16(3.2) years. A strong association of gender preferences towards male child and unmet need exist, which is highly significant. Conclusion: Unmet need is high despite extensive family planning program in Nepal. Mean age at marriage below legal age, low female education and gender discrimination are the factors responsible for unmet need.     

Fertility,knowledge, attitude and practice (KAP) study in relation to family planning in a selected population of the Armed Forces

A study was carried out among the civil and military population in Poona, India, to determine their knowledge, attitude, and practices in relation to family planning and the fertility rates of women aged 15-44 in the following catagories: 1) total and age specific marital fertility rate; 2) order of birth of the children born during the previous year; 3) average number of living children per couple; and 4) percentage of currently pregnant women. 251 civilian wives and 230 military wives were interviewed. Both total marital fertility rates and age specific marital fertility rates were high among the Service families, due perhaps to the predominance of young people in the military. Most of the live births occurring in the previous year were of the 1-3 order. Similarly, the average number of children per couple was low, only 1.7, although the number of children in completed families (4.4) was not too much lower than in civilian Poona families (4.8) and in India in general (5.5). Nearly 2/3 considered 3 children the ideal, although the desire for boys was intense and could lead couples to seek more than 3 children. Only 10% favored abortion on demand. More Service than civilian families knew about and practiced family planning, though the number practicing was only 27.8%. The most widely known methods were sterilization, the condom, and the IUD. The image of family planning among the civilian population was of family limitation, whereas some Service personnel regarded it as a means of child spacing. Practice of family planning was highest among Junior Commissioned Officers, the more literate, and those in the 30-34 age group. There was a positive correlation between family planning practice and number of living children. It is recommended that fertility statistics on military personnel be maintained annually. Further, as it was discovered that 20% of the military wives were currently pregnant, the family welfare planning staff and maternal health services and the Military Hospitals have a good opportunity to provide service for both the limitation and spacing of families.     

Role of planned parenthood for enrichment of the quality of life in Sri Lanka

The story of the Sri Lankan Family Planning movement is told from its inception in 1953, prompted by a visit by Margaret Sanger 1952. The Family Planning Association of Sri Lanka was founded with the health of women and children, and both contraception and infertility treatment as its policies. The first clinic, called the "Mothers Welfare Clinic," treated women for complications of multiparity: one woman was para 26 and had not menstruated in 33 years. The clinic distributed vaginal barriers, spermicides and condoms, but the initial continuation rate was 5% year. Sri Lanka joined the IPPF in 1954. In 1959, after training at the Worcester Foundation, and a personal visit by Pincus, the writer supervised distribution of oral contraceptives in a pilot project with 118 women for 2 years. Each pill user was seen by a physician, house surgeon, midwife, nurse and social worker. In 1958 Sweden funded family planning projects in a village and an estate that reduced the birth rate 10% in 2 years. The Sri Lankan government officially adopted a family planning policy in 1965, and renewed the bilateral agreement with Sweden for 3 years. In 1968 the government instituted an integrated family planning and maternal and child health program under its Maternal and Child Health Bureau. This was expanded in 1971 to form the Family Health Bureau, instrumental in lowering the maternal death rate from 2.4/1000 in 1965 to 0.4 in 1984. During this period IUDs, Depo Provera, Norplant, and both vasectomy and interval female sterilizations, both with 1 small incision under local anesthesia, and by laparoscopic sterilization were adopted. Remarkable results were being achieved in treating infertile copies, even from the beginning, often by merely counseling people on the proper timing of intercourse in the cycle, or offering artificial insemination of the husband's semen. Factors contributing to the success of the Sri Lankan planned parenthood program included 85% female literacy, training of health and NGO leaders, government participation, approval of religious leaders, rising age of marriage to 24 years currently, and access of all modern methods.     

Effects of age, cigarette smoking, and other factors on fertility: findings in a large prospective study

Of 17 032 women taking part in the Oxford Family Planning Association contraceptive study, 4104 stopped using a birth control method to plan a pregnancy on a total of 6199 occasions. The influence of various factors on fertility in these women was assessed by measuring the time taken to give birth to a child. An appreciable inverse relation was observed between age at stopping contraception and fertility both in nulliparous and parous women, but the effect was much greater in the nulliparous women. The most important finding was a consistent and highly significant trend of decreasing fertility with increasing numbers of cigarettes smoked per day; it was estimated that five years after stopping contraception 10.7% of smokers smoking more than 20 cigarettes a day, but only 5.4% of non-smokers, remained undelivered. Some relation was found between fertility and social class, age at marriage, and a history of gynaecological disease, but weight, height, and Quetelet's index were without noticeable effect.     

影响低出生体重的危险因素及巨大儿状况研究

采用体检与问卷相结合的方式,对425名妇女从婚姻期到围生期进行追踪调查,用STATA3.1软件分析处理,筛查危险因素,以探讨低体重儿的危险因素及巨大儿状况。结果表明影响低体重儿的危险因素为双胎、孕期营养不良；婚姻家庭支持程度差（丈夫外出家人关心少）、家庭协调差（男方亲属干预家庭经济）及家庭暴力（丈夫殴打妻子）；家庭经济计划差及人均收入低、业余爱好跳舞、逛商店、个人有不良嗜好（打麻将）均可促进低体重儿的发生。巨大儿易引起相对头盆不称、宫缩乏力、分娩困难及母儿双方的损伤,可因颅内出血引起后遗症及围生期死亡率增高。结果提示为降低低体重儿的发生率,孕期应进行生理、心理、婚姻家庭及社会因素全方位保健。胎儿体重不是愈大愈好，对巨大儿应适当进行干预，控制孕妇体重在适当范围内才对胎儿有利。     

Predictors of bone mineral density in female workers in Morelos State, Mexico

BACKGROUND: Although several studies have identified factors associated with bone mineral density (BMD), little research is available on Mexican women. METHODS: A cross-sectional study was conducted in 1,622 female workers between 20 and 80 years of age at the Mexican Social Security Institute (IMSS), an integral part of the Mexican health system. It was carried out in Morelos, a Mexican state that borders Mexico City. Women were recruited to participate in this study from their workplaces. Body mass index (BMI) was measured and BMD was assessed using dual-energy x-ray absorptiometry of dominant forearm. Predictors of BMD (age, reproductive factors, BMI, diet, and physical activity) in pre- and postmenopausal women were assessed by questionnaire and analyzed using generalized additive models. RESULTS: In premenopausal women, older age, higher BMI, younger age at menarche, and greater vitamin D intake were associated with higher BMD (R(2)=0.06, null deviance reduction=6.9%). In postmenopausal women, determinants of BMD were older age, higher BMI, greater height, later initiation of menopause, longer time of use of hormonal replacement therapy (HRT), and greater calcium intake from dairy products (R(2)=0.39, null deviance reduction=40.7%). CONCLUSIONS: As observed in other populations, age, BMI, height, age at menopause, time of use of HRT, and calcium intake derived from dairy products in these Mexican women are factors associated with higher forearm BMD during postmenopausal period. Age, BMI, age at menarche, and vitamin D are associated with higher forearm BMD in premenopausal women. Some of these factors are not linearly associated with BMD. This was a limited population study carried out in a large group of female healthcare workers whose reproductive and lifestyle factors potentially agreed with those of female workers from urban areas of Mexico.     

Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan

In a study in 29 health centre districts in Japan 91 540 non-smoking wives aged 40 and above were followed up for 14 years (1966-79), and standardised mortality rates for lung cancer were assessed according to the smoking habits of their husbands. Wives of heavy smokers were found to have a higher risk of developing lung cancer and a dose-response relation was observed. The relation between the husband's smoking and the wife's risk of developing lung cancer showed a similar pattern when analysed by age and occupation of the husband. The risk was particularly great in agricultural families when the husbands were aged 40-59 at enrolment. The husbands' smoking habit did not affect their wives' risk of dying from other disease such as stomach cancer, cervical cancer, and ischaemic heart disease. The risk of developing emphysema and asthma seemed to be higher in non-smoking wives of heavy smokers but the effect was not statistically significant. The husband's drinking habit seemed to have no effect on any causes of death in their wives, including lung cancer. These results indicate the possible importance of passive or indirect smoking as one of the causal factors of lung cancer. They also appear to explain the long-standing riddle of why many women develop lung cancer although they themselves are non-smokers. These results also cast doubt on the practice of assessing the relative risk of developing lung cancer in smokers by comparing them with non-smokers.     

Assessment of fertility control efforts in a selected area of Karachi, Pakistan

AIMS: To investigate the impact of fertility control efforts on reducing fertility and to study the contributory role of fertility inhibiting factors viz, age of the marriage, breast feeding and post-partum amenorrhea, abortion and use of contraceptives in selected area in Karachi, Pakistan. The aim was to estimate the gap between knowledge of contraceptives and its practice i.e. KAP-GAP as well as to determine the level of unmet need in the PIB colony in Karachi. DATA SOURCE: A sample survey was conducted in PIB colony in Karachi from October 2005 to November 2005 by interviewing 340 married women in reproductive ages. The data was tabulated and John Bongaarts technique was used to analyse the success of fertility control efforts in the selected area. RESULTS: Of the total of 340 respondents, 38% were currently using contraceptive methods with 26% using OCP's and 12% were condom users. A slight reduction in total fertility (TFR) was noticed. CONCLUSION: The population policy of Pakistan envisages achieving population stabilization in 2020 by reducing the annual rate of population growth from 1.9% to 1.3% and TFR at 2.1. This target requires strenuous efforts to make the concept of small family an accepted milieu through an eagerly designed communication and education campaign. Concentration on proximate determinants of fertility particularly breast feeding and prolonging birth interval will not generate opposition from the community because these concepts are in accordance with Islamic injunctions and teachings.     

285例中期妊娠引产原因分析

目的探讨致中期妊娠引产的原因,以保护妇女身心健康和生殖健康。方法回顾性分析2008年1月～2010年12月在我院进行中期妊娠引产的病例285例。结果大多数中期妊娠引产者为无业或无固定职业人员,平时未采取任何避孕措施。青少年和未婚者妊娠中期引产率较高。结论中期妊娠引产与职业、年龄、文化水平、婚姻状况等因素有关。加强性教育和计划生育措施的宣传,可以减少中期妊娠引产。同时,晚婚晚育也是减少中期妊娠引产的重要措施之一。     

农村已婚育龄妇女生育健康卫生需求调查

目的 了解云南省少数民族地区已婚育龄妇女的生育健康卫生需求。方法 用定量调查表入户进行调查和小组定性调查。结果 医院分娩率、产前检查率和产后访视率较低,家属接生和旧法接生率较高,已婚育龄妇女的文化程度和经济收入低,节育器的使用率最高达到46．8％,但是未采取任何避孕措施仍达25．5％。结论 提高家庭经济收入,加强已婚育龄妇女的文化知识教育,特别是健康教育和改变健康观念,才能提高已婚育龄妇女的卫生需求和利用及生命质量,宣传教育和培训方法可根据当地实际情况采取丰富多彩的方式,可用农村参与性评估（PRA）的方法进行,应加强已婚育龄妇女家属的共同教育。     

农村已婚育龄妇女宫颈糜烂危险因素的病例-对照研究

研究农村已婚育龄妇女宫颈糜烂的危险因素。方法：对2?996名农村已婚育龄妇女进行结构式问卷调查、临床和实验室检查，采用单因素与多因素Logistic分析病例组和对照组宫颈糜烂情况及危险因素。结果：农村已婚育龄妇女宫颈糜烂患病的危险因素中，学历以文盲为基线，小学、初中、高中的OR分别为0.505、0.397与0.404；在医院分娩为基线，家中分娩的OR为1.65；初婚年龄以≤22岁为基线，23～24岁、≥25岁的OR分别为0.53、0.59。结论：为了减少农村已婚育龄妇女宫颈糜烂，应加强健康教育，提倡晚婚晚育，推行计划生育，普及科学接生。     

重庆地区妇女生殖道感染现状及影响因素的研究

目的了解重庆地区妇女生殖道感染的患病情况及影响因素.方法对1 001例16～55岁妇女进行问卷调查、妇科检查和实验室检查,最后进行统计分析.结果重庆地区妇女生殖道感染的患病率56.5%,其中患1种生殖道感染的占71.9%,2种占19.4%,3种或3种以上的占8.7%.经多因素logistic回归分析发现爱人职业、结婚年龄、性伴侣数、学历、生殖道感染史、家庭经济、宫腔操作史、经期性生活、初次性生活年龄等因素为生殖道感染发生的影响因素,单因素分析发现避孕套是保护性因素.结论重庆地区妇女生殖道感染患病率较高,应引起政府部门及医疗机构的重视.针对妇女生殖道感染的影响因素进行有效的预防和干预,以减少生殖道感染疾病的发生,最终提高重庆地区人群的生殖健康水平.     

青少年妊娠与婚前性行为危险模式探讨

采用多状态Ｌｏｇｉｓｔｉｃ回归分析法，对婚前检查者６２０例和青少年人工流产者１７２便的生殖健康危险模式进行了分析研究，结果表明，本人和男友的文化职业、家庭教育、恋爱年龄、恋爱时间是青少年婚前性行为与妊娠的危险因素。     

南充市育龄妇女受孕力现状调查

目的:掌握南充市育龄妇女受孕力现状。方法:采用横断面设计,以医院首次进行孕前超声检查的人为对象,回顾性收集受孕等待时间和相关因素;引入离散时间模型计算累计怀孕率和识别影响因素。结果:共调查1 374人,平均计划怀孕年龄为(21.65±2.37)岁,3、6、12月累积怀孕概率依次为64.38%,77.45%和88.18%,不孕率为11.82%。计划怀孕年龄、文化程度和避孕方式与受孕力存在明显关联。结论:不同地区影响受孕力的因素存在分布差异,因此人群受孕力也明显不同。     

贫困地区育龄妇女滴虫性阴道炎相关因素分析

目的　了解西北农村贫困地区育龄妇女滴虫性阴道炎感染现状及其相关因素 ,确定危险因素。方法采用多级整群抽样方法 ,在陕西省宝鸡地区抽取已婚育龄妇女 4 80例进行问卷调查、妇科检查和实验室检查 ,采用病例对照研究分析滴虫性阴道炎及相关生殖道感染的危险因素。结果　滴虫性阴道炎患病率为 12 .9% ,其中 6 4 .5 %并发慢性宫颈炎 ,17.7%并发附件炎。经单因素分析及多因素 L ogistic回归分析 ,农村育龄妇女患滴虫性阴道炎及并发慢性宫颈炎或附件炎的危险因素包括 :生殖健康知识缺乏、不洁水洗澡、本人或其丈夫同房前用不洁水洗外阴、经期性生活、既往滴虫病史、本人无经济来源、生病时丈夫态度消极 ;且随着生殖健康知识积分的逐渐减少 ,患滴虫性阴道炎并发慢性宫颈炎的危险性相对增大。结论　在西北贫困地区 ,对滴虫性阴道炎应采取综合性、连续性防治措施进行控制 ,重点应放在改善夫妇不洁卫生习惯、规范治疗、生殖健康知识的普及、动员男性参与四个方面     

先天出生缺陷相关因素研究结果分析

目的对影响围产儿出生缺陷相关因素进行研究。方法按照1：2配对进行病例对照研究,调查研究地区研究期间1岁以内的出生缺陷儿童母亲110例,同期同年龄段正常儿童母亲236例,了解出生缺陷发生的主要相关危险因素。结果在孕妇职业、异常生育史、营养状况、体力劳动、情绪情况、被动吸烟、避孕药服用史、家族遗传史、家族中近亲婚配史、妊娠合并症、妊娠并发症、接触有害因素、孕期服药情况、患感染疾病情况、接受优生优育宣教、接受孕产期保健等15项因素,出生缺陷组与对照组比较,有统计学意义（P〈0.05）。结论应广泛开展优生优育咨询及孕产期保健,有效减少先天出生缺陷的发生。