Cohort studies Archives - Revista Brasileira de Ginecologia e Obstetrícia
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):761-770
, , , , , , , , The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population.
This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016.
Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group.
From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):761-770
, , , , , , , , The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population.
This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016.
Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group.
From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):749-756
To describe caffeine consumption during pregnancy and its association with low birth weight (LBW) and preterm birth in the birth cohort of Ribeirão Preto, state of São Paulo, Brazil, in 2010.
Cohort study, with descriptive and analytical approach. Data included 7,607 women and their newborns in Ribeirão Preto, state of São Paulo, Brazil. The women answered standardized questionnaires about reproductive health, prenatal care, life habits, sociodemographic conditions, and information about coffee intake. The independent variable was high caffeine consumption (≥300 mg/day) from coffee during pregnancy, and the dependent variables were LBW (birth weight < 2,500 g) and preterm birth (< 37 weeks of gestational age). Four adjusted polytomous logistic regression models, relative risk (RR) and 95% confidence interval (CI) were fitted: biological and sociodemographic conditions; obstetric history; current gestational conditions; and all variables included in the previous models.
A total of 4,908 (64.5%) mothers consumed caffeine, 143 (2.9%) of whom reported high consumption. High caffeine intake was significantly associated with reduced education and with the occupation of the head of the family, nonwhite skin color, not having a partner, higher parity, previous abortion and preterm birth, urinary tract infection, threatened abortion, alcohol consumption and smoking. No association was found between high caffeine consumption and LBW or preterm birth in both
In this cohort, high caffeine intake was lower than in other studies and no association with LBW or preterm birth was found.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):749-756
To describe caffeine consumption during pregnancy and its association with low birth weight (LBW) and preterm birth in the birth cohort of Ribeirão Preto, state of São Paulo, Brazil, in 2010.
Cohort study, with descriptive and analytical approach. Data included 7,607 women and their newborns in Ribeirão Preto, state of São Paulo, Brazil. The women answered standardized questionnaires about reproductive health, prenatal care, life habits, sociodemographic conditions, and information about coffee intake. The independent variable was high caffeine consumption (≥300 mg/day) from coffee during pregnancy, and the dependent variables were LBW (birth weight < 2,500 g) and preterm birth (< 37 weeks of gestational age). Four adjusted polytomous logistic regression models, relative risk (RR) and 95% confidence interval (CI) were fitted: biological and sociodemographic conditions; obstetric history; current gestational conditions; and all variables included in the previous models.
A total of 4,908 (64.5%) mothers consumed caffeine, 143 (2.9%) of whom reported high consumption. High caffeine intake was significantly associated with reduced education and with the occupation of the head of the family, nonwhite skin color, not having a partner, higher parity, previous abortion and preterm birth, urinary tract infection, threatened abortion, alcohol consumption and smoking. No association was found between high caffeine consumption and LBW or preterm birth in both
In this cohort, high caffeine intake was lower than in other studies and no association with LBW or preterm birth was found.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240
DOI 10.1590/S0100-72032007000500003
PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240
DOI 10.1590/S0100-72032007000500003
PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):410-415
DOI 10.1590/S0100-72032006000700006
PURPOSE: to verify, through pelvic ultrasound, the existence of changes in the internal genitalia of girls with central precocious puberty, submitted to treatment with gonadotrophin-releasing hormone (GnRH) analogs. METHODS: pelvic ultrasound was performed in 18 girls with idiopathic central precocious puberty, before and after three months of onset of the treatment with GnRH analogs, to investigate the impact of the therapy on the internal genitalia. Ovarian and uterine volumes, uterine longitudinal length, relation between the longitudinal diameter of the uterine corpus and the uterine cervix, the relation between the anterior-posterior diameter of the uterine corpus and the uterine cervix, and endometrial echogenicity were evaluated. Statistical analysis was performed through Shapiro-Willkis's test, to assess data normality. When normality was present, Student's test t was applied. For data without normality, a non-parametric test (the signal test) was used. RESULTS: after therapy, statistically significant decline of the mean uterine volume (from 5.4 cm³ to 3.0 cm³, p<0.001), of the mean ovarian volume (from 2.2 cm³ to 1.1 cm³, p= 0.004), of the mean uterine longitudinal length (from 4.2cm to 3.4 cm, p=0.001), and of the mean endometrial echogenicity (from 1.8 mm to 0.6 mm, p=0.018) occurred. CONCLUSION: In girls with idiopathic central precocious puberty, pelvic ultrasound is a valid method to assess the efficacy of treatment with GnRH analogs. The main parameters of the therapeutic response were the decrease of uterine and ovarian volume, of uterine longitudinal length, and atrophy or absence of endometrial echogenicity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):410-415
DOI 10.1590/S0100-72032006000700006
PURPOSE: to verify, through pelvic ultrasound, the existence of changes in the internal genitalia of girls with central precocious puberty, submitted to treatment with gonadotrophin-releasing hormone (GnRH) analogs. METHODS: pelvic ultrasound was performed in 18 girls with idiopathic central precocious puberty, before and after three months of onset of the treatment with GnRH analogs, to investigate the impact of the therapy on the internal genitalia. Ovarian and uterine volumes, uterine longitudinal length, relation between the longitudinal diameter of the uterine corpus and the uterine cervix, the relation between the anterior-posterior diameter of the uterine corpus and the uterine cervix, and endometrial echogenicity were evaluated. Statistical analysis was performed through Shapiro-Willkis's test, to assess data normality. When normality was present, Student's test t was applied. For data without normality, a non-parametric test (the signal test) was used. RESULTS: after therapy, statistically significant decline of the mean uterine volume (from 5.4 cm³ to 3.0 cm³, p<0.001), of the mean ovarian volume (from 2.2 cm³ to 1.1 cm³, p= 0.004), of the mean uterine longitudinal length (from 4.2cm to 3.4 cm, p=0.001), and of the mean endometrial echogenicity (from 1.8 mm to 0.6 mm, p=0.018) occurred. CONCLUSION: In girls with idiopathic central precocious puberty, pelvic ultrasound is a valid method to assess the efficacy of treatment with GnRH analogs. The main parameters of the therapeutic response were the decrease of uterine and ovarian volume, of uterine longitudinal length, and atrophy or absence of endometrial echogenicity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):509-514
DOI 10.1590/S0100-72032005000900002
PURPOSE: to evaluate the luteal function in adolescents with regular menstrual cycles. METHODS: this prospective cohort study included 55 adolescents, aged 14-19 years, with menarche at 12.2 years. Ovulation was identified by ultrasound, starting on the second or fifth day of the cycle. The corpus luteum vascularization and the resistence index of the ovarian vessels were measured by Doppler on the tenth postovulatory day. Progesterone was measured by chemoluminescence on days 6, 9 and 12 of the luteal phase. The endometrial biopsy was performed 8 to 10 days after ovulation. The results were analyzed using the SPSS software and were considered significant when p<0.05. RESULTS: on average ovulation was on day 17. Progesterone levels were 11.4, 10.9 and 3.9 ng/mL on days 6, 9, and 12 after ovulation, respectively; the progesterone mean during the whole luteal phase was 10.3 ng/ml. Luteal vascularization was scarce in 34.6%, mild in 23.6% and exuberant in 41.8%. The resistance index was 0.441. On the tenth day post-ovulation the endometrium was normal in 85.5% and out-of-phase in 14.5%. There was no correlation between the ovulation day and endometrial dating (p=0.294), levels of progesterone and endometrial dating (p=0.454), progesterone and corpus luteum vascularization (p=0.994), or resistance index (p=0.237). There also was no association between endometrium development and degree of vascularization (p=0.611). CONCLUSION: abnormal luteal function in adolescents with regular menstrual cycles was found in 14.5%. Degree of vascularization, resistance index, and serum progesterone were not related to endometrium development.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):509-514
DOI 10.1590/S0100-72032005000900002
PURPOSE: to evaluate the luteal function in adolescents with regular menstrual cycles. METHODS: this prospective cohort study included 55 adolescents, aged 14-19 years, with menarche at 12.2 years. Ovulation was identified by ultrasound, starting on the second or fifth day of the cycle. The corpus luteum vascularization and the resistence index of the ovarian vessels were measured by Doppler on the tenth postovulatory day. Progesterone was measured by chemoluminescence on days 6, 9 and 12 of the luteal phase. The endometrial biopsy was performed 8 to 10 days after ovulation. The results were analyzed using the SPSS software and were considered significant when p<0.05. RESULTS: on average ovulation was on day 17. Progesterone levels were 11.4, 10.9 and 3.9 ng/mL on days 6, 9, and 12 after ovulation, respectively; the progesterone mean during the whole luteal phase was 10.3 ng/ml. Luteal vascularization was scarce in 34.6%, mild in 23.6% and exuberant in 41.8%. The resistance index was 0.441. On the tenth day post-ovulation the endometrium was normal in 85.5% and out-of-phase in 14.5%. There was no correlation between the ovulation day and endometrial dating (p=0.294), levels of progesterone and endometrial dating (p=0.454), progesterone and corpus luteum vascularization (p=0.994), or resistance index (p=0.237). There also was no association between endometrium development and degree of vascularization (p=0.611). CONCLUSION: abnormal luteal function in adolescents with regular menstrual cycles was found in 14.5%. Degree of vascularization, resistance index, and serum progesterone were not related to endometrium development.