Effects of early cat or dog ownership on sensitisation and asthma in a high‐risk cohort without disease‐related modification of exposure

Almqvist C, Garden F, Kemp AS, Li Q, Crisafulli D, Tovey ER, Xuan W, Marks GB for the CAPS investigators. Effects of early cat or dog ownership on sensitisation and asthma in a high‐risk cohort without disease‐related modification of exposure. Paediatric and Perinatal Epidemiology 2010; 24: 171–178. Variation in the observed association between pet ownership and allergic disease may be attributable to selection bias and confounding. The aim of this study was to suggest a method to assess disease‐related modification of exposure and second to examine how cat acquisition or dog ownership in early life affects atopy and asthma at 5 years. Information on sociodemographic factors and cat and dog ownership was collected longitudinally in an initially cat‐free Australian birth cohort based on children with a family history of asthma. At age 5 years, 516 children were assessed for wheezing, and 488 for sensitisation. Data showed that by age 5 years, 82 children had acquired a cat. Early manifestations of allergic disease did not foreshadow a reduced rate of subsequent acquisition of a cat. Independent risk factors for acquiring a cat were exposure to tobacco smoke at home odds ratio (OR) 1.92 [95% confidence interval (CI) 1.13, 3.26], maternal education ≤12 years OR 1.95 [1.08, 3.51] and dog ownership OR 2.23 [1.23, 4.05]. Cat or dog exposure in the first 5 years was associated with a decreased risk of any allergen sensitisation, OR 0.50 [0.28, 0.88] but no association with wheeze OR 0.96 [0.57, 1.61]. This risk was not affected by age at which the cat was acquired or whether the pet was kept in‐ or outdoors. In conclusion, cat or dog ownership reduced the risk of subsequent atopy in this high‐risk birth cohort. This cannot be explained by disease‐related modification of exposure. Public health recommendations on the effect of cat and dog ownership should be based on birth cohort studies where possible selection bias has been taken into account.     

Changes in the prevalence of asthma, eczema and hay fever in pre-pubertal children: a 40-year perspective

Surveys of primary schools children in Aberdeen carried out in 1964, 1989, 1994 and 1999 suggested a slowing of the increase in parent-reported wheeze between 1994 and 1999. To assess whether this pattern had continued, questionnaires were distributed to 5712 children aged 7–12 years in the same schools in 2004. A total of 3271 (57.3%) completed questionnaires were returned. As in earlier surveys the results were divided into those for younger children (school years 3–4; age 7–9 years) and older children (school years 5–7; age 9–12 years).
Compared with 1999, the 2004 results showed a decrease in the proportion of children with wheeze in the last 3 years from 30.1% to 23.3% ( P  < 0.001) in the younger group and from 27.6% to 25.1% ( P  = 0.052) in the older group. There was no significant change in the lifetime prevalence of asthma in either the younger or the older group, but the lifetime prevalence of eczema and hay fever increased by around 10% in both the younger and older groups (all P  < 0.001). The differences in the time trends for the different conditions suggest that the causal factors for wheeze and asthma differ from those for other allergic diseases of childhood.     

Formulating selection policies for assisted reproduction

This paper addresses one of the most important problems in the area of assisted reproduction, namely the selection policies used by the providers of the services. Some of the difficulties involved in formulating policies in this area are outlined. The paper concludes that public involvement in decision making in this area is vital, and that to facilitate this the issues must be opened up to public scrutiny and debate. Such a debate would be a significant first step towards the implementation of policies which reflect the opinion of the entire community rather than just the professionals who provide the service, or sectional groups who manage to influence the professionals.     

Atopic diseases and related risk factors among Dutch adolescents

BACKGROUND: The aim of the present study was to gain insight into the prevalence of asthma, allergic rhinitis, and eczema among Dutch early adolescents, and to study the impact of several social demographic and individual risk factors. METHODS: Cross-sectional survey study using the self-report questionnaires of the International Study of Asthma and Allergies in Childhood (ISAAC). In January 2003, 10 087 12- to 14-year-old students from 33 secondary schools in four regions of the Netherlands participated in this study. RESULTS: Of all participants, 52.6% reported that they had an allergic disease at least once in their lifetime. The 12 months prevalence of wheezing, rhinitis, and itchy rash was 12.3%, 28.3%, and 13.5%, respectively. Several social demographic and individual factors (gender, age, education levels, ethnicity, body mass index, and residential area) were significantly associated with the atopic symptoms and diseases. CONCLUSION: This study showed that allergic conditions are common in the Netherlands. Several social demographic and individual risk factors were related to the atopic diseases and symptoms.     

Neonatal sepsis, antibiotic therapy and later risk of asthma and allergy

Sobko T, Schiött J, Ehlin A, Lundberg J, Montgomery S, Norman M. Neonatal sepsis, antibiotic therapy and later risk of asthma and allergy. Paediatric and Perinatal Epidemiology 2010; 24: 88–92.
Neonatal sepsis and early antibiotic therapy affect bacterial colonisation and immune activation after birth. This could have implications for later risk of allergy and asthma. Using a validated questionnaire (International Study of Asthma and Allergies in Children, ISAAC), we screened for asthma and allergy in three cohorts (total n  = 834; median age 12, range 7–23 years) with different perinatal exposures as regards infection and antibiotics.
Asthma, but not hay fever, was more prevalent after neonatal sepsis with adjusted odds ratio (OR) 1.63 [95% confidence interval (CI) 1.04, 2.56] and early antibiotic therapy (OR 1.48 [0.93, 2.35]) as compared with a control group. There was a trend towards increased atopic eczema after neonatal sepsis (OR = 1.39 [CI = 0.98, 1.98]). We conclude that neonatal sepsis is associated with an increased risk for later development of asthma. Early antibiotic exposure may contribute to this association.     

辅助生殖助孕双绒毛膜双胎出生体质量不均衡的高危因素分析

目的 分析辅助生殖助孕双绒毛膜双胎出生体质量不均衡的高危因素.方法 选取2017年3月-2020年12月在甘肃省妇幼保健院分娩的双胎出生体质量不均衡的133例孕妇为病例组,双胎出生体质量均衡的266例孕妇为对照组.采用Logistic回归分析法分析双胎出生体质量不均衡的危险因素.结果 病例组妊娠期高血压疾病、妊娠期肝内...     

Drug tolerability in assisted reproduction techniques: a longitudinal study

A longitudinal, observational prospective panel cohort study of 61 patients lasting one year was undertaken. Explanatory variables included sociodemographic factors along with factors related to the underlying pathology as well as the protocol used and the type of treatment received. These variables were analyzed both individually and in combination to account for confounding effects and model interactions. A generalized estimating equation (GEE) model was constructed for each adverse effect. Associations were calculated as odds ratios (OR). Confounding variables related to drug tolerability were identified. Follitropin-alpha and cetrorelix exhibited the poorest safety profile. With respect to local adverse drug reactions (ADEs), the results obtained in our study point to statistically significant tolerability improvements for menotropin when administered in insemination. For gastrointestinal ADEs, ganirelix was the drug that showed the highest tolerability in in vitro treatments whereas follitropin-alpha showed the lowest tolerability in insemination treatments. Diverse factors related to assisted reproduction techniques (ART) influence the incidence of adverse effects. Each drug has a different safety profile with possible interactions depending on the type of assisted reproduction therapy used.     

Atopic and non-atopic asthma in a farming and a general population

BACKGROUND: In a previous study inverse associations between asthma and exposure to fungal spores and endotoxins in atopic farmers and positive associations with the same factors in non-atopic farmers were documented. No external reference population had been included. We, therefore, compared this farming population with the general population from an adjacent region. METHODS: Random samples of a farming (n=2,106) and a rural (n=351) and urban (n=727) general population were selected. Atopy was assessed by serum IgE and asthma by questionnaires. RESULTS: The asthma prevalence was 4.0% among farmers, 5.7% in the rural, and 7.6% in the urban population. Atopy was similar (9-10%). Most asthmatics were not atopic, 67-75%. Farmers had asthma less often than the general population OR 0.52 (95% CI 0.36-0.75); both atopic (OR 0.33 (95% CI 0.15-0.69)) and non-atopic asthma (OR 0.60 (95% CI 0.39-0.93)). CONCLUSION: This may indicate a protective effect of the farm environment on asthma but a healthy worker effect may also play a role.     

辅助生殖技术试管足月儿神经心理行为发育的纵向研究

目的 比较辅助生殖技术(ART)试管足月儿的体格发育、神经心理行为发育水平与自然受孕(NC)婴儿的差异,为促进试管婴儿早期全面发展提供科学依据.方法 采用1∶1对照研究方法,于2019年1月1日-2020年12月31日期间纳入60例ART足月儿和60例NC足月儿收集相关信息,并随访6月龄和12月龄健康体检信息,采用儿-...     

APIKIDS: a cohort of children born after assisted reproductive technologies

A cohort of children born after assisted reproductive technologies (ART) was set up in 2003 in Italy. It aims to follow up the children in order to study the short- and long-term effects of ART. Parents who agreed to participate were contacted for a telephone interview; questions included occupational and non-occupational exposure to carcinogens, reproductive history, history of index pregnancy (including drugs used during pregnancy), delivery and the child's health status. By August 2005, 40 out of the 50 centres contacted (80%) had agreed to participate in the study, and 17 had already sent their data. Information on a total of 2451 cycles ending with a pregnancy are currently available, from 2245 couples. We have contacted 351 of these couples (16%), 309 of whom (88% of the contacts) agreed to participate in the study and were interviewed, while 36 (11%) refused to be interviewed. The total number of children currently included in the database is 411. This study is the first attempt to create a database containing information on children born after ART in Italy. It will provide results on both short- and long-term outcomes in these children.     

辅助生殖技术受孕单胎早产儿出生结局和认知发育的纵向研究

目的 分析辅助生殖技术(ART)受孕单胎早产儿与自然受孕(NC)单胎早产儿出生结局、婴儿期认知发育水平的差异,为ART受孕单胎早产儿的早期全面健康发展指导提供科学依据。方法 2019年1月1日—2021年7月31日期间纳入28例ART早产儿与34例NC早产儿并收集相关信息,并于6月龄、12月龄进行体格检查和儿童神经心理行为发育测评(儿心-2016版)。结果 ART单胎早产儿父母生育年龄(t=2.536、2.055)、妊娠合并症发生率(χ²=11.442)、剖宫产率(χ²=6.115)、低出生体重率(χ²=4.736)均高于NC组,差异有统计学意义(P<0.05),但两组早产儿出生体重、身长以及6月龄和12月龄身长、体重及增长值的差异均无统计学意义(P>0.05)。ART单胎早产儿6月龄总发育商、精细运动、语言发育商(92.23±8.15、88.38±7.64、89.95±12.35)均低于NC组,警示行为发育商(3.57±3.12)高于NC组,差异均有统计学意义(t=2.376、2.163、2.142、2.4...     

我国人类辅助生殖技术评估概述

目的：为了了解我国人类辅助生殖技术现状，为制定相关政策提供依据。方法：采用流行病学，社会学调查等方法进行调研。结果：1999年底，实施IVF的机构达70家左右，还有些正在筹建或准备筹建，但有一定的规模的辅助生殖技术中心太少，而IVF的妊娠并发症比自然妊娠要高得多，另外，目前的精子，卵子和孕卵的管理及实施ART技术中还涉及到许多伦理、法规问题没有解决，而过快发展主要受到益驱动所致，结论：加强对ART技术管理非常迫切，特别是对IVF技术的安全性应高度关注，并应尽快加强ART的相关法律法律建设等。     

Infertility in Australia circa 1980: an historical population perspective on the uptake of fertility treatment by Australian women born in 1946‐51

Objective: To estimate the prevalence of lifetime infertility in Australian women born in 1946‐51 and examine their uptake of treatment. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1946‐51 (n=13,715) completed up to four mailed surveys from 1996 to 2004. The odds of infertility were estimated using logistic regression with adjustment for socio‐demographic and reproductive factors. Results: Among participants, 92.1% had been pregnant. For women who had been pregnant (n=12738): 56.5% had at least one birth but no pregnancy loss (miscarriage and/or termination); 39.9% experienced both birth and loss; and 3.6% had a loss only. The lifetime prevalence of infertility was 11.0%. Among women who reported infertility (n=1511), 41.7% used treatment. Women had higher odds of infertility when they had reproductive histories of losses only (OR range 9.0‐43.5) or had never been pregnant (OR=15.7, 95%CI 11.8‐20.8); and higher odds for treatment: losses only (OR range 2.5‐9.8); or never pregnant (1.96, 1.28‐3.00). Women who delayed their first birth until aged 30+ years had higher odds of treatment (OR range 3.2‐4.3). Conclusions: About one in ten women experienced infertility and almost half used some form of treatment, especially those attempting pregnancy after 1980. Older first time mothers had an increased uptake of treatment as assisted reproductive technologies (ART) developed. Implications: This study provided evidence of the early uptake of treatment prior to 1979 when the national register of invasive ART was developed and later uptake prior to 1998 when data on non‐invasive ART were first collected.     

Successful pregnancy following assisted reproduction and transmyometrial embryo transfer in a patient with anatomical distortion of the cervical canal

Abstract

Presented is the case report of a patient noted to have gross distortion of the internal cervical canal during her attempt at embryo transfer following an in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) procedure. Multiple attempts at cervical dilation were unsuccessful and the patient was ultimately treated by transmyometrial embryo transfer also known as the Towako method. She successfully achieved a singleton pregnancy and delivered at 41 weeks by primary cesarean section because of arrest of cervical dilation. Transmyometrial embryo transfer represents a viable option for patients with cervical stenosis refractory to conventional methods of navigation or severe anatomical distortion of the internal cervical canal.     

Motherhood and assisted reproduction in a religious context: Genes,stigma and supports in Utah,United States

Six percent of cisgender (i.e. not transgender) women aged 15–44 are considered infertile in the United States, and 12% are unable to carry a pregnancy to term. For those who yearn to create a family despite these circumstances, assisted reproductive technology (ART) is an often-utilised resource. Though faith-based institutions have been referenced as a source of support for involuntarily childless adults, it is unclear how religious doctrine, especially that which prizes 'traditional' gender roles and genetic parenthood, may be a catalyst for distress. More research is needed to understand how the socio-cultural environment affects those who are unable to conceive without assistance. Therefore, the purpose of this research study was to understand the lived experiences of women who have utilised assisted reproduction in a particularly pronatalist, religious cultural context in the United States. From March to September 2017, in-depth interviews were conducted with 10 cisgender women who had utilised ART. Data analysis was conducted in NVivo 10 and consisted of line-by-line analysis, identifying themes, coding categories and developing matrices to uncover relationships between themes and categories. The quest for motherhood was truly a journey for the study participants who experienced rumination and self-blame due to their inability to become pregnant. This was rooted in their socio-cultural context. Thus, the study findings suggest that culture and stigma are linked with women's distress regarding their inability to become pregnant and results in distancing from other women. Genetic parenthood was prized initially, but this desire decreased over time. While past research suggests that infertility strains relationships, our study found that the turmoil of infertility and assisted reproduction actually strengthened couple relationships. Counselling was described as particularly helpful, but it is needed throughout the assisted reproduction process. The inclusion of religion and spirituality, for those who identify as such, in counselling would be beneficial.     

Increased incidence of latex allergy in children with allergic diseases in Japan

The incidence of latex allergy is increasing in Japanese adults. However, the changing incidence of latex allergy in children with or without allergic diseases has not been reported in detail. After obtaining written informed consent from parents, Japanese children under 14 years of age were studied. In total, 776 non-atopic children, 802 children with allergic rhinitis (AR), 706 children with bronchial asthma (BA) and 844 children with atopic eczema/dermatitis syndrome (AEDS) were asked about symptoms of latex allergy, and tested by serum latex-specific IgE, skin prick test to latex allergen and latex-glove-wearing test between 2001 and 2003. All the patients were outpatients at Ujitakeda Hospital, while the non-atopic children were children of the staff of Ujitakeda Hospital or Unitika Ltd. This was a retrospective study. The incidence of latex allergy in 2001/2002/2003 was 1.4/3.1/4.7% in non-atopic children, 3.1/5.1/9.1% in AR patients, 3.6/6.5/10.3% in BA patients and 6.1/11.3/15.9% in AEDS patients, respectively. Moreover, although no cases of anaphylactic shock were noted in allergic patients in 2001, two and eight cases were noted in 2002 and 2003, respectively. These results indicate that the incidence of latex allergy is increasing in paediatric patients with allergic diseases. A latex-reduced environment may be desirable in future.     

Live birth after assisted reproductive technology treatment in a case with lumboperitoneal shunt following intracranial pathology

Lumbar peritoneal shunt is a technique of cerebrospinal fluid diversion from the lumbar thecal sac to the peritoneal cavity. By diverting, a second compartment of the body; abdomen starts to accompany the case as a new problem source. 32 years old woman who had been considered to be primary infertile for fifteen years applied to our infertility clinic. She had a transsphenoidal surgery due to macroadenoma of pituitary gland fourteen years ago. By trans-vaginal ultrasonography we revealed 4 antral follicles and diffuse ascites in pouch of douglas due to the shunt. There were spicular projections fom uterus and bowel serosa to inner abdominal wall, that we thought about severe intraabdominal adhesions. Controlled ovarian hyperstimulation was started with 300 IU menotropin on third day of the cycle. We yielded 4 oocyte. One grade-1 embryo transferred at day two. After two weeks hCG positivity was determined. At 39th week 3 900 g female baby was born vaginaly with 1st minute apgar score as 9 and 5th minute apgar score as 10.     

辅助生殖技术助孕后子代出生缺陷风险:基于队列研究的Meta分析

目的评估辅助生殖技术(assisted reproductive technology,ART)助孕对子代出生缺陷的影响。方法检索从建库到2018年8月在PubMed、Embase、Cochrane图书馆、Sinomed、CNKI、万方、维普数据库中满足预先纳入标准的队列研究,使用I2统计和Q-检验评估研究之间的统计异质性,使用固定效应模型或随机效应模型估计总体组合的风险。结果本次最终纳入60项研究进行Meta分析,评估ART助孕后的子代730756名和自然受孕(spontaneously conceived,SC)的子代26185008名的出生缺陷风险。与SC子代相比,ART助孕后的子代出生缺陷风险高[RR=1.42,95%CI(1.30-1.56)]。排除异质性大的1项研究后,余下59项研究在限定部分条件后,其出生缺陷风险的变化如下,泌尿生殖器畸形[RR=1.49,95%CI(1.40-1.59)],单胎畸形[RR=1.43,95%CI(1.30-1.58)],亚洲地区[RR=1.52,95%CI(1.28-1.80)],基于临床的研究[RR=1.36,95%CI(1.21-1.60)],小样本量的研究[<500,RR=1.52,95%CI(1.35-1.72)],分层分析后,ART助孕后的子代出生缺陷风险高于SC子代。结论ART助孕子代出生缺陷风险高于SC组,因此在ART助孕后必须进行严格产前筛查,以避免严重畸形儿的出生。