Environmental contaminants exposure and preterm birth: a systematic review

Preterm birth is an obstetric condition associated with a high risk of infant mortality and morbidities in both the neonatal period and later in life, which has also a significant public health impact because it carries an important societal economic burden. As in many cases the etiology is unknown, it is important to identify environmental factors that may be involved in the occurrence of this condition. In this review, we report all the studies published in PubMed and Scopus databases from January 1992 to January 2019, accessible as full-text articles, written in English, including clinical studies, original studies, and reviews. We excluded articles not written in English, duplicates, considering inappropriate populations and/or exposures or irrelevant outcomes and patients with known risk factors for preterm birth (PTB). The aim of this article is to identify and summarize the studies that examine environmental toxicants exposure associated with preterm birth. This knowledge will strengthen the possibility to develop strategies to reduce the exposure to these toxicants and apply clinical measures for preterm birth prevention

Tlr4 t399i polymorphism and endometriosis in a cohort of italian women

Endometriosis is a widespread multifactorial disease in which environmental, genetic, and epigenetic factors contribute to the phenotype. Single Nucleotide Polymorphisms (SNPs) in genes implicated in pivotal molecular mechanisms have been investigated as susceptible risk factors in distinct populations. Among these, Toll-like receptor 4 (TLR4) represents a good candidate due to its role in the immune/inflammatory response and endometriosis pathogenesis

Modification of body composition and metabolism during oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol

Aim: To observe the influence on metabolism and body composition of two oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol (EE). Study design: Women on hormonal contraception with estradiol valerate (E2V)/dienogest (DNG) in a quadriphasic regimen (n 1\u20444 16) or 30 mg EE/2 mg chlormadinone acetate (CMA) (n 1\u20444 16) in a monophasic regimen were evaluated at the third cycle for modifications in lipoproteins, apoproteins and homeostatic model assessment for insulin resistance (HOMA-IR), and at the sixth cycle for body composition and the markers of bone turnover osteocalcin and C-telopeptide X. Results: During E2V/DNG lipoprotein, apoproteins and HOMA-IR remained stable. During EE/CMA, total-cholesterol (p1\u204440.003), high-density lipoprotein (HDL)-cholesterol (p1\u204440.001), triglycerides (p 1\u20444 0.003) Apoprotein-A1 (Apo-A1; p 1\u20444 0.001) and Apo B (p 1\u20444 0.04) increased, low- density lipoprotein/HDL (p1\u204440.039) decreased and total-cholesterol/HDL and Apoprotein- B/Apo-A1 ratio did not vary. HOMA-IR slightly increased from 1.33\ub10.87 to 1.95\ub10.88 (p1\u204440.005). There was a reduction of markers of bone metabolism in both groups with no modification of body composition. Conclusions: Administration of E2V/DNG does not influence lipid and glucose metabolism, while mixed effect are exerted by EE/CMA. Both preparations reduce bone metabolism without influencing short-term effect on body composition

Influence of an oral contraceptive containing drospirenone on insulin sensitivity of healthy women

Oral contraceptives (OCs) containing androgenic second and third generation progestins decrease insulin sensitivity (SI). In this study we investigated whether an oral contraceptive containing the anti-androgenic progestin drospirenone (DRSP) still alters SI. Lipid modifications were investigated as well

Folate administration decreases oxidative status and blood pressure in postmenopausal women

The purpose of this study was to evaluate whether folate exerts antioxidant effects in postmenopausal women and whether this effect is related to folate-induced modification of 24-h ambulatory blood pressure (BP)

Prospective measurement of blood pressure and heart rate over 24 h in women using combined oral contraceptives with estradiol

Objective: Combined oral contraceptives (COCs) containing ethinyl-estradiol are known to increase blood pressure (BP). We evaluated whether COCs containing estradiol (E2) influence 24-h ambulatory BP and heart rate (HR) in normotensive and normal-weight women. Study design: Twenty-four-hour BP and HR were measured every 30 min with an ambulatory BP device in 18 normotensive healthy non-smoking women prior to (Days 3-6 of menstrual cycle) and after 6 months of use (Days 20-24 of cycle 6) of a COC containing either a quadriphasic combination of E2 valerate plus dienogest (n=11) or a monophasic association of micronized E2 plus nomegestrol acetate (n=7). Results: Mean age and body mass index of the final sample were 32.50\ub17.49 years and 22.87\ub14.08, respectively. E2-based COCs induced no modification of 24-h systolic BP (+1.65\ub18.34 mmHg; p=.41), diastolic BP (+0.04\ub17.36 mmHg; p=.98), mean BP (+0.64\ub16.42 mmHg; p=.68) or HR (-0.72\ub15.86 beats/min; p=.61). Differences were not observed even when daytime or nighttime values were separately considered. Though this was not a comparative study, we did not find differences between the effects of the two formulations (24-h mean BP; p=.699). Conclusions: These data suggest a neutral effect of estradiol-based COCs on independent risk factors for cardiovascular diseases such as BP or HR. Implications: BP and HR of normotensive women are not increased by E2-based COC

Use of contraception by women with induced abortion in Italy

Objectives: To investigate type of contraception, if any, used by women with induced abortion. Methods: Retrospective analysis on the medical records of 1782 women with induced abortion performed at the University Hospital of Modena (Italy) between 2009 and 2011. Results: Some kind of contraception was used by 81.1% of women with induced abortion. At time of conception most of these women (39%) had used withdrawal, 19.0% natural methods, 15.2% condom, 7% hormonal contraception (95% estrogen plus progestin for any route) and 0.4% copper-IUD. None was using implants or levonorgestrel-IUD. Figures of past use of hormonal contraception were much higher than those present at the time of the unwanted pregnancy (50.3% vs. 7%; p<0.0001). A higher prevalence of condom use (19.7% vs. 10.9%; p<0.0001), and a lower prevalence of natural methods (14.5% vs. 21.6%; p<0.001) were found in single vs. married women. Use of no contraception was more prevalent among low vs. highly educated women with induced abortion (22.2% vs. 14.2%; p<0.02), but was not related to marital status. Prevalence of use of the different contraceptives is different from the one described in the general population, suggesting differences in contraceptive efficacy among the different methods. Conclusions: Women with induced abortion infrequently use long term or hormonal contraception. In half of the cases the latter has been used at least once in life, but then it has been abandoned. Appropriate education and contraceptive counselling, personalization and follow-up may reduce induced abortion

Prospective measurement of blood pressure and heart rate over 24 h in women using combined oral contraceptives with estradiol

Objective: Combined oral contraceptives (COCs) containing ethinyl-estradiol are known to increase blood pressure (BP). We evaluated whether COCs containing estradiol (E2) influence 24-h ambulatory BP and heart rate (HR) in normotensive and normal-weight women. Study design: Twenty-four-hour BP and HR were measured every 30 min with an ambulatory BP device in 18 normotensive healthy non-smoking women prior to (Days 3-6 of menstrual cycle) and after 6 months of use (Days 20-24 of cycle 6) of a COC containing either a quadriphasic combination of E2 valerate plus dienogest (n=11) or a monophasic association of micronized E2 plus nomegestrol acetate (n=7). Results: Mean age and body mass index of the final sample were 32.50\ub17.49 years and 22.87\ub14.08, respectively. E2-based COCs induced no modification of 24-h systolic BP (+1.65\ub18.34 mmHg; p=.41), diastolic BP (+0.04\ub17.36 mmHg; p=.98), mean BP (+0.64\ub16.42 mmHg; p=.68) or HR (-0.72\ub15.86 beats/min; p=.61). Differences were not observed even when daytime or nighttime values were separately considered. Though this was not a comparative study, we did not find differences between the effects of the two formulations (24-h mean BP; p=.699). Conclusions: These data suggest a neutral effect of estradiol-based COCs on independent risk factors for cardiovascular diseases such as BP or HR. Implications: BP and HR of normotensive women are not increased by E2-based COC