RESUMO
OBJECTIVE: To assess the association between condom use and oral contraceptive consumption and the risk of cervical intraepithelial neoplasia (CIN). METHODS: A cross-sectional study was conducted in Perth clinics. A total of 348 women responded to the structured questionnaire. Information sought included demographic and lifestyle characteristics such as the use of condom for contraception, consumption of oral contraceptive, and duration of oral contraceptive usage. Crude and adjusted odds ratio (OR) and associated 95% confidence interval (CI) were calculated using unconditional logistic regression models and reported as estimates of the relative risk. RESULTS: The prevalence of CIN was found to be 15.8%. The duration of oral contraceptive consumption among women with abnormal Papanicolaou (Pap) smear result indicating CIN was significantly shorter than those without abnormal Pap smear result (mean+/-SD, 5.6+/-5.2 years vs. 8.2+/-7.6 years; p=0.002). Comparing to or =10 years reduced the risk of CIN (p=0.012). However, use of condom for contraception might not be associated with a reduced risk of CIN after accounting for the effects of confounding factors (adjusted OR, 0.52; 95% CI, 0.05 to 5.11; p=0.577). CONCLUSION: Use of oral contraceptives, but not condoms, for contraception appeared to be inversely associated with CIN. Prolonged use of oral contraceptive demonstrated its benefits of reducing the risk of CIN.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Displasia do Colo do Útero/epidemiologia , Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais Orais/administração & dosagem , Estudos Transversais , Esquema de Medicação , Uso de Medicamentos/estatística & dados numéricos , Prevalência , Medição de Risco/métodos , Fatores Socioeconômicos , Austrália Ocidental/epidemiologiaRESUMO
The structure and provision mechanism of maternity services in Nepal appearsto be good, with adequate coverage and availability. Utilization of maternityservices has also improved in the past decade. However, this progress may not beadequate to achieve the Millennium Development Goal to improve maternal health(MDG 5) in Nepal. This paper reviews the factors that impede women from utilizingmaternity services and those that encourage such use. Twenty-one articles wereexamined in-depth with results presented under four headings: (i) socioculturalfactors; (ii) perceived need/benefit of skilled attendance; (iii) physical accessibility;and (iv) economic accessibility. The majority of the studies on determinants ofservice use were cross-sectional focusing on sociocultural, economic and physicalaccessibility factors. In general, the education of couples, their economic statusand antenatal check-ups appeared to have positive influences. On the otherhand, traditional beliefs and customs, low status of women, long distance tofacilities, low level of health awareness and women’s occupation tended to impactnegatively on service uptake. More analytical studies are needed to assess theeffectiveness of the Safer Mother Programme, expansion of rural birth centres andbirth-preparedness packages on delivery-service use. Moreover, it is important toinvestigate women’s awareness of the need of facility delivery and their perceptionof the quality of health facilities in relation to actual usage
Assuntos
Serviços de Saúde Materna , NepalRESUMO
OBJECTIVE: To investigate the association between reproductive factors and the risk of ovarian cancer among southern Chinese women. METHODS: A hospital-based case-control study was undertaken in Guangzhou, Guangdong Province, between 2006 and 2008. A structured questionnaire was used to obtain information on parity, oral contraceptive use and other reproductive factors in a sample of 500 incident ovarian cancer patients and 500 controls (mean age, 59 years). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression models. RESULTS: High parity was inversely associated with ovarian cancer, with an adjusted OR 0.43 (95% CI, 0.30 to 0.62) for women who had given birth to 3 or more children compared to women who had given no more than one birth. Ever use of oral contraceptives was also protective against ovarian cancer; adjusted OR 0.56 (95% CI, 0.40 to 0.78). No association was found for hormone replacement therapy, menopausal status, hysterectomy and family history of ovarian and/or breast cancer. CONCLUSION: High parity and oral contraceptive use are associated with a lower risk of ovarian cancer in southern Chinese women.
Assuntos
Criança , Feminino , Humanos , Povo Asiático , Mama , Estudos de Casos e Controles , China , Anticoncepcionais Orais , Terapia de Reposição Hormonal , Histerectomia , Modelos Logísticos , Razão de Chances , Neoplasias Ovarianas , Paridade , Parto , Inquéritos e QuestionáriosRESUMO
Green tea is a popular beverage and its health benefits are well known. However, inconsistent results have been reported in observational studies concerning the association between green tea consumption and the lung cancer risk. In this commentary, several methodological issues underlying the measurement of tea exposure are highlighted. The recommendations should be useful for designing and planning prospective cohort studies to ascertain the protective effect of green tea against lung cancer.
Assuntos
Humanos , Neoplasias Pulmonares/etiologia , Medição de Risco , Chá/efeitos adversosRESUMO
The objective of this study was to describe the problems experienced by mothers when breastfeeding and the impact that these problems have on breastfeeding duration. A cohort of 556 mothers who birthed in Perth, Western Australia were recruited to study their infant feeding practices. The mothers were interviewed in hospital and again at 2, 6, 10, 14, 18 and 24 weeks postpartum, or until they ceased to breastfeed. The results showed that most mothers were not prepared to experience any difficulties or problems with breastfeeding. Twelve percent of the mothers left hospital without having attempted to breastfeed. The most common reasons given for infant-formula-feeding related to previous problems with breastfeeding, the ability of husbands to assist with feeding and perceived ease of bottle-feeding. While in hospital 83% of breastfeeding women stated that they had experienced one or more problems related to breastfeeding. Two weeks after leaving hospital 29% of breastfeeding mothers were experiencing problems and the prevalence of problems continued to decline, reaching 13% at six months. In this study the most common reason cited by mothers for stopping breastfeeding before the baby was two weeks old, was that their baby was unsettled, a behaviour often interpreted by mothers as indicating an insufficient milk supply. Levels of anxiety over milk supply reached 23% in the early stages of breastfeeding, and a number of mothers were still experiencing anxiety through to six months. Anxiety over the sufficiency of breastmilk supply was the most serious problem, in that it often resulted in the cessation of breastfeeding Most mothers experience some problems during breastfeeding, especially in the early stages. Proper advice and management is required to ensure that the problems do not lead to cessation of breastfeeding.