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Purpose: Pregnancy and childbirth are normal conditions, but complications and adverse outcomes are common. Both genetic and environmental factors influence the course of pregnancy. Genetic epidemiologic research into pregnancy outcomes could be strengthened by the use of common measures, which would allow data from different studies to be combined or compared. Here, we introduce perinatal researchers to the PhenX Toolkit and the Collections related to pregnancy and childbirth., Methods: The Pregnancy and Birth Collections were drawn from measures in the PhenX Tooklit. The lead author selected a list of measures for each Collection, which was reviewed by the remaining authors and revised on the basis of their comments. We chose the measures we thought were most relevant for perinatal research and had been linked most strongly to perinatal outcomes., Results: The Pregnancy and Birth Health Conditions Collection includes 24 measures related to pregnancy and fertility history, maternal complications, and infant complications. The Pregnancy and Birth Outcome Risk Factors Collection includes 43 measures of chemical, medical, psychosocial, and personal factors associated with pregnancy outcomes., Conclusions: The biological complexity of pregnancy and its sensitivity to environmental and genomic influences suggest that multidisciplinary approaches are needed to generate new insights or practical interventions. To fully exploit new research methods and resources, we encourage the biomedical research community to adopt standard measures to facilitate pooled or meta-analyses., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The Duke Data Bank for Cardiovascular Diseases is an observational data bank capturing baseline, treatment, and follow-up information on patients referred for evaluation of suspected coronary artery disease. From 6829 patients referred between 1969 and 1990 for diagnostic angiography, baseline cholesterol levels were determined as part of the standard clinical procedure. Baseline total cholesterol values were found to be related to the presence of coronary disease in men and women, although in the elderly little evidence for a significant relationship was found. Formal tests for interactions revealed a significant interaction between age and cholesterol but not between gender and cholesterol. In subgroup analyses using the Cox proportional hazards model, no relationship was found between cholesterol and either cardiovascular death or total cardiac events (death or nonfatal myocardial infarction) in 2038 medically treated patients with 5 to 20 years of follow-up. In the subgroup of 1798 surgically treated patients, there was also no relationship between baseline cholesterol level and these end points. Finally, detailed lipid analysis was done at baseline and 6-month angiography in a second population of 759 patients undergoing percutaneous coronary angioplasty between 1986 and 1989. No substantial relationship between baseline or follow-up cholesterol, low-density or high-density lipoproteins, or triglyceride levels and restenosis was found.

The value of serum total cholesterol measurement in predicting coronary heart disease (CHD) is well established in middle-aged men, but has been questioned in middle-aged women and older people of both sexes. To address this, the most recent follow-up data from 25 populations in 22 US and international cohort studies were presented and analyzed at a recent National Heart, Lung, and Blood Institute (NHLBI) workshop. Crude relative and absolute excess risks of fatal CHD were determined for individual studies and pooled across studies to determine pooled risk estimates. Serum total cholesterol and low-density-lipoprotein (LDL) cholesterol levels predicted fatal CHD in middle-aged (< 65 years) and older (> or = 65 years) men and women, though the strength and consistency of these relationships in older women were diminished. High-density-lipoprotein (HDL) cholesterol levels inversely predicted CHD in middle-aged men and women and in older women, but not in older men. Data for minority groups and for overseas populations were similar to those for white people in the United States. Relative risk estimates were generally lower for older than for middle-aged subjects, but absolute excess risk was greater. Older people and middle-aged women with elevated cholesterol levels are clearly at increased risk of coronary disease; whether this risk can be modified by dietary or drug therapy, and at what level intervention is appropriate, must not be determined.