Reproductive history and blood cell DNA methylation later in life: the Young Finns Study

Background Women with a history of complications of pregnancy, including hypertensive disorders, gestational diabetes or an infant fetal growth restriction or preterm birth, are at higher risk for cardiovascular disease later in life. We aimed to examine differences in maternal DNA methylation following pregnancy complications. Methods Data on women participating in the Young Finns study (n = 836) were linked to the national birth registry. DNA methylation in whole blood was assessed using the Infinium Methylation EPIC BeadChip. Epigenome-wide analysis was conducted on differential CpG methylation at 850 K sites. Reproductive history was also modeled as a predictor of four epigenetic age indices. Results Fourteen significant differentially methylated sites were found associated with both history of pre-eclampsia and overall hypertensive disorders of pregnancy. No associations were found between reproductive history and any epigenetic age acceleration measure. Conclusions Differences in epigenetic methylation profiles could represent pre-existing risk factors, or changes that occurred as a result of experiencing these complications.

Association of Reproductive History With Brain MRI Biomarkers of Dementia Risk in Midlife

Objective.To examine associations between indicators of estrogen exposure from women’s reproductive history and brain MRI biomarkers of Alzheimer’s disease (AD) in midlife.Methods.We evaluated 99 cognitively normal women ages 52+6 years, and 29 men ages 52+7 years, with reproductive history data, neuropsychological testing, and volumetric MRI scans. We used multiple regressions to examine associations between reproductive history indicators, voxel-wise gray matter volume (GMV), memory and global cognition scores, adjusting for demographics and midlife health indicators. Exposure variables were menopause status, age at menarche, age at menopause, reproductive span, hysterectomy status, number of children and pregnancies, use of menopause hormonal therapy (HT) and hormonal contraceptives (HC).Results.All menopausal groups exhibited lower GMV in AD-vulnerable regions as compared to men, with peri-menopausal and post-menopausal groups also exhibiting lower GMV in temporal cortex as compared to the pre-menopausal group. Reproductive span, number of children and pregnancies, use of HT and HC were positively associated with GMV, chiefly in temporal cortex, frontal cortex, and precuneus, independent of age, APOE-4 status, and midlife health indicators. Although reproductive history indicators were not directly associated with cognitive measures, GMV in temporal regions was positively associated with memory and global cognition scores.Conclusions.Reproductive history events signaling more estrogen exposure, such as pre-menopausal status, longer reproductive span, higher number of children, use of HT and HC, were associated with larger GMV in midlife women. Further studies are needed to elucidate sex-specific biological pathways through which reproductive history influences cognitive aging and AD-risk.

The Influence of Reproductive History on Post-Reproductive Mortality: A Case Study of Amish Women

The reproductive choices women make affect their health outcomes; however, the relevance of reproductive history on post-reproductive mortality varies according to the population under study. We examine whether the number of children a woman gives birth to, short birth intervals, late childbearing, having twins, and having children who die young have an influence on maternal mortality among the Amish. We use information from Amish directories to examine reproductive patterns of 228 women in this high fertility group. Our results indicate the patterns typically found for maternal mortality in the general population do not hold in our sample of Amish women. We suggest the mediating role of family and community is integral to understanding the maternal health patterns within the Amish community.

Reproductive History in Takotsubo Syndrome, A Register-Based Cohort Study

Background: Takotsubo syndrome (TS) is a recently recognized serious heart condition that mainly affects women. Despite that 80–90% of the patients are women, few studies have focused on sex-specific characteristics such as female sex hormones and reproductive history. The aim of the study was to compare reproductive history in patients with TS with controls.Methods: This register-based cohort study compared reproductive history and off-spring birth characteristics between 158 TS patients without coronary artery stenoses and 236 age- and sex-matched controls (C) with coronary artery stenoses because of acute coronary syndrome (ACS-C), respectively, 285 without coronary artery stenoses with chest pain (CP-C).Results: There were no differences in pregnancy complications between TS and CP-C. Gestational length did not differ, but infants born to TS patients had lower birth weight for gestational age than CP-C with an odds ratio of 1.7 (95% confidence interval 1.2–2.5) for infants born small.Conclusion: The results showing an association between birth weight for gestational age and TS later in life are hypothesis-generating. The association is not likely causal and before delivery of small for gestational age infants can be considered as a risk marker for TS later in life the results need to be confirmed in independent studies

Characteristic of the karyotype of products of conception depending on reproductive history of women

Aim. The prognosis of the reproductive function of women with pregnancy loss is complex and partly based on the results of karyotyping of material of reproductive loss. We studied the features of the karyotype of material of EPL depending on the reproductive history of women with an emphasis on viable and non–viable karyotype abnormalities(KA). Methods. Banding cytogenetic and interphase mFISH with the centromeric probe panel for chromosomes 13, 14, 15, 16, 17, 18, 21, 22, X and Y were used. Results. Were examined 1734 cases of material EPL. Abnormal karyotype was set in 39.3% of cases. The frequency of KA is not significantly different in the material of EPL obtained from women with different reproductive history, namely: first pregnancy loss– 38.9% RPL – 38.2% and SPL – 41.0% (P> 0.05). In the group with RPL significantly more frequent non–viable KA and less viable KA, compared with a group of SPL namely 70.15% and 29.85% compared to 58.85% and 41.15% respectively(P<0.025). Conclusions. The contribution of different KA in genesis of the EPL depends on the reproductive history of women, namely women with RPL significantly increases the proportion of non–viable KA and reduced contribution viable KA compared with a group of SPL. Keywords: early reproductive loss, maternal reproductive history, karyotype abnormalities.

Reproductive History and Age of Onset for Women Diagnosed with Amyotrophic Lateral Sclerosis: Data from the National ALS Registry: 2010–2018

<b><i>Background:</i></b> Amyotrophic lateral sclerosis (ALS) is a neurological disease of largely unknown etiology with no cure. The National ALS Registry is a voluntary online system that collects demographic and reproductive history (females only) data from patients with ALS. We will examine the association between demographic and reproductive history among female patients aged &#x3e;18 years and various ages of onset for ALS. <b><i>Methods:</i></b> Data from a cross-sectional study were collected and examined for 1,018 female ALS patients. Patient characteristics examined were demographics including race, BMI, and familial history of ALS. Among patients, information on reproductive history, including age at menopause, ever pregnant, and age at first pregnancy was collected. Unadjusted and adjusted logistic regression models were used to estimate OR and 95% CI in this study. <b><i>Results:</i></b> Women were more likely to be diagnosed with ALS before age 60 if they were nonwhite (<i>p</i> = 0.015), had attended college (<i>p</i> = 0.0012), had a normal BMI at age 40 (<i>p</i> &#x3c; 0.0001), completed menopause before age 50 (<i>p</i> &#x3c; 0.0001), and had never been pregnant (<i>p</i> = 0.046) in the univariate analysis. Women diagnosed with ALS before age 60 were also more likely to have limb site of onset (<i>p</i> &#x3c; 0.0001). In the multivariate analysis, those who completed menopause before age 50 were more likely to be diagnosed with ALS before age 60 (OR = 1.8, 95% CI: 1.4–2.3) compared with women who completed menopause at or after age 50, after controlling for race, ever pregnant, age at first pregnancy, family history of ALS, education status, smoking history, and BMI at age 40. For women who were diagnosed with ALS before age 50, the odds of them entering menopause before age 50 climb to 48.7 (95% CI: 11.8, 200.9). The mean age of ALS diagnosis for women who completed menopause before age 50 was 58 years and 64 years for women who entered menopause after age 50 (<i>p</i> &#x3c; 0.0001). <b><i>Conclusion:</i></b> Women who reported completing menopause before age 50 were significantly more likely to be diagnosed with ALS before age 60 compared with those who reported entering menopause after age 50. More research is needed to determine the relationship between female reproductive history, especially regarding endogenous estrogen exposure and early-onset ALS.

P–136 Factors predicting clinical outcomes of 511 recipients of vitrified oocyte donation from an UK-regulated egg bank

Study question Do established donor and recipient clinical markers predict recipient clinical pregnancy and live birth rates (LBRs) in a vitrified oocyte donation programme? Summary answer Recipient BMI and previous miscarriages predicted cumulative LBR. Likelihood of clinical pregnancy and LBR was higher in recipients of donors aged 23–29 than donors 18–22. What is known already The influence of age on ovarian reserve underlies the upper limit of 35 years for UK donors. However, recent evidence suggests that oocyte aneuploidy rates follow an inverse U-shaped curve in relation to a woman’s age. Conflicting evidence exists regarding the impact of other donor-related factors including BMI, AMH, oocyte yield and prior reproductive history on recipient outcomes. Moreover, the effect of recipient age, BMI, and reproductive history on oocyte donation outcome remains unclear. Study design, size, duration Retrospective cohort study of 325 altruistic oocyte donors matched to a total of 511 recipients. Only first donations taking place between January 2017 and December 2019 were included. Participants/materials, setting, methods All oocyte donors were altruistic volunteers aged 18–35 with no prior infertility diagnosis. Donor and recipient screening for suitability and safety was carried out according to the Human Fertilisation Embryology Authority guidelines. Backward stepwise logistic regression was used to identify donor, recipient and embryology parameters predictive of recipient primary outcomes defined as clinical pregnancy and live birth, either cumulative or after the first embryo transfer (ET). Main results and the role of chance A total of 705 fresh and frozen/thawed ETs were performed, of which 76% were elective single embryo transfers (eSETs) of blastocysts (96.5%), resulting in a cumulative clinical pregnancy and LBR of 83.5% and 70.5% respectively after 3 ETs. Recipient BMI and previous miscarriages were predictors of cumulative LBR (p &lt; 0.05). The ratio of transferrable embryos per oocytes received/fertilised and the number of ETs needed to achieve the intended primary outcome were predictors of cumulative clinical pregnancy and LBR (p &lt; 0.05). Donor age 18–22 was associated with lower incidence of recipient clinical pregnancy and live birth after the first ET, as compared to donor age 23–29 (p &lt; 0.05). Limitations, reasons for caution The present study included only healthy oocyte donors, thus conclusions may not apply to subfertile or less healthy women. Male factors were not accounted for. Wider implications of the findings: We demonstrate the efficacy of vitrified oocyte donation treatment and identify recipient BMI, previous miscarriages and embryology parameters as predictors of cumulative LBR. Additionally, the choice of donors aged 18–22 instead of older donors is found not to be advantageous for increasing the chance of clinical pregnancy and live birth. Trial registration number Not applicable

Client Satisfaction with Contraceptive Counseling and Associated Factors in Public Health Institutions: A Cross-Sectional Study Design

Objective: The main objective of the study was to assess client satisfaction with contraceptive counseling and associated factors among women attending the family planning clinics in Asella town public health institutions, Ethiopia. Methods: Study subjects were selected using systematic random sampling and data were collected using interviewer administered and entered into software for analysis. Multivariate logistic regression model was used to predict the relation between variables and a significant of statistics was assured using 95% CI and p value < 0.05 was considered as significant predictor. Results: This study revealed that 62.8% of the study respondents were satisfied with contraceptive counseling. Multiple logistic regression models showed that, being urban in residence, time taken to reach nearby health facility, being asked reproductive history, explained side effects, privacy ensured, asked worries and concern about the method and use of the leaflet were predictors associated with client satisfaction with contraceptive counseling. Conclusions: About 62.8% of clients were satisfied with contraceptive counseling. Being urban in residence, time taken to reach nearby health facilities, explains side effects, being asked reproductive history, worries and concern about the method and use of the leaflet were factors associated with client satisfaction with contraceptive counseling