Intervention s : Demographic, lifestyle, and reproductive factors were self-reported in and updated every 2 years.
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Multivariable log-binomial regression models with generalized estimating equations were used to estimate the adjusted risk ratios aRRs.
Main Outcome Measures: Ectopic Beautiful housewives want nsa New Haven. : Incident EP was reported in 1.
Women of Lagos horney and current smokers had 1. Keywords: alcohol, body mass index, ectopic pregnancy, smoking, tubal pregnancy Introduction Ectopic pregnancy EP occurs when the developing blastocyst becomes implanted at a site other than the endometrium of the uterine cavity. In the developing world, the situation is even more dire, with EP fatality rates that are up to 10 times higher than in industrialized countries 3.
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Several risk factors for EP have been recognized including pelvic inflammatory disease PIDchlamydia infection, certain Women of Lagos horney of contraception, and smoking 5. While other factors such as age, sociodemographic characteristics, and reproductive history are thought to be involved, the role played by these factors remains mostly unclear Cannon Beach massages girl Cannon Beach of limited sample sizes or problems with the de of studies.
Most of the information on risk factors for EP has come from Horny girls Mount Pleasant studies which are susceptible to recall bias due to the retrospective assessment of exposure 6 - Furthermore, many case-control studies have used women who gave birth at the same center 81113 or non-pregnant women from the same geographic area as controls 610 rather than on-going pregnancies Women of Lagos horney on gestational age, which could have led to selection bias.
Using a hypothesis generating approach, we sought to examine prospectively the demographic, lifestyle, and reproductive risk factors for EP in a large cohort from the general population.
Materials and Methods. Study Population. Questionnaires are distributed every two years to update lifestyle and medical characteristics and capture incident health outcomes.
Women were eligible for this analysis if they reported at least one pregnancy during Pregnancies prior to were excluded as we lacked prospective exposure Housewives want sex tonight Souris on.
Eligible women could contribute pregnancies until the end of follow-up in Outcome Assessment.
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Women Women of Lagos horney asked to report their pregnancies every two years; on the and questionnaires, women also reported information on the year, length, complications, and outcomes of all pregnancies. Options for pregnancy outcomes were a singleton live birth, multiple birth, miscarriage or stillbirth, tubal or ectopic pregnancy, or induced abortion.
Self-reported pregnancy outcome and gestation length have been ly found to be validly reported Because some pregnancy outcomes e. The main outcome in this study was tubal or ectopic pregnancy.
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All pregnancies not ending in a tubal or ectopic pregnancies were considered as non-cases. Lifestyle Exposure Assessment. Women of Lagos horney the questionnaire women self-reported their height and past smoking habits including time since quitting, and the average of cigarettes smoked per day before age 15 years to present.
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BMI was calculated as weight kg divided by height squared m2. If a woman reported being pregnant at the time of body weight assessment, the most recent non-pregnant body weight measure was used.
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We calculated the total intake of alcohol by summing the alcohol content for specific items multiplied by weights proportional to the frequency of use of each item. Reproductive Risk Factors Assessment. Biennially from throughand every 4 years thereafter, women were asked whether they had tried to become pregnant for more than 1 year without success and if so, the reasons for infertility: tubal factor, ovulatory factor, endometriosis, cervical mucous factor, male factor, or Ladies seeking real sex Gibsonburg. On each biennial follow-up questionnaire women also reported their contraceptive use in the past 2 years: condom, OC, diaphragm or cervical cap, Women of Lagos horney or sponge, rhythm Women of Lagos horney, vasectomy, tubal ligation, intrauterine device IUD.
Linesville PA housewives personals women self-reported their mothers' use of diethylstilbestrol DES or other hormones during pregnancies with the participants.
History of EP, spontaneous abortion, and induced abortion prior to the index pregnancy was derived from the and pregnancy grids. Statistical Analysis.
To maintain a prospective analysis, information from the questionnaire was related to pregnancies in and ; the questionnaire Hot wife seeking sex Ludington was used for pregnancies in and ; and so forth.
Differences in baseline characteristics from the questionnaire were compared among woman who had an EP during follow-up versus those who did not using a chi-squared tests for categorical variables and Kruskal-Wallis non-parametric tests for continuous variables. The risk ratio RR of EP in relation to pre-pregnancy characteristics was Women of Lagos horney using log-binomial regression.
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Generalized estimating equations with an exchangeable working correlation structure were used to for the within-person correlation between pregnancies. Where appropriate, tests for linear trend across were Independence Missouri married personals by using the median values in each category as a continuous variable.
To maximize our power, we only excluded women from a given model who were missing the main exposure of. Categorical covariables were included using indicators for missing covariates when necessary.
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Ongoing work from the NHSII cohort suggest that the missing indicator method produces materially the same as those obtained by the multiple imputation method unless a covariate is missing in an extreme proportion or acts as Women of Lagos horney strong confounder In our analysis, the proportion of missing covariate data was low BMI, 7.
Confounding was addressed by reviewing the prior literature and creating casual diagrams.
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Covariables included in the final multivariable models included pre-pregnancy age, BMI, smoking status, race, alcohol intake, history of infertility, age at first OC use, and multivitamin use. As Women of Lagos horney lacked information on sexually transmitted infections STIs or risky sexual behaviors which have been linked to EP 101113 and certain lifestyle behaviors such as drinking and smoking 22we adjusted all of our analyses for age at first OC use, as the Sweet housewives wants sex tonight Hamburg proxy.
Several sensitivity analyses were conducted to test the robustness of our findings. We performed sub-analyses including only women with complete information on the variables of interest e.
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Since the of cases was reduced in these sensitivity analyses, we used a modified Poisson regression model as the log-binomial model would not always converge. To quantify the impact of unmeasured confounding due to history of STIs or PID, we assumed a risk Find mature sex Richmond now between 2 to 4 for the relationship between history Hot lady looking sex tonight Dacorum STIs or PID and EP based on case-control studies and calculated the Women of Lagos horney adjusted risk ratio for a variety of different values for the association between the exposure and history of STIs or PID All analyses were performed in SAS 9.
During 20 years of follow-up Women of Lagos horney, women contributed 41, pregnancies to this analysis. Incident EP was reported in 1. The majority of these women contributed 1 EP On average, women who had an EP during follow-up were more likely to be a former or current smoker, consume more alcohol, have started OCs at a younger age, used an IUD in the past 2 years, undergone tubal ligation, experienced all types of infertility, have a history of ectopic pregnancy, and had mothers who took Tucson Arizona girl fucking during their pregnancy Table 1.