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Background: Environmental tobacco smoke (ETS) exposure during pregnancy can cause preterm delivery and childhood cancer. The aim of this study was to measure ETS exposure in pregnant women and in newborn infants in Israel using urinary cotinine measurements, to assess predictors of ETS exposure in these vulnerable groups, and to assess associations with birth effects (birth weight, birth length, head circumference) in newborn infants.Methods: We analyzed urinary cotinine and creatinine in 265 non-smoking pregnant women and 97 newborns, and analyzed associations with self-reported exposure to ETS, paternal smoking, sociodemographic variables and with birth outcomes (birth weight, birth length, head circumference).Results: 37.7% of pregnant women and 29.0% of infants had urinary cotinine concentrations above the level of quantification (LOQ) of 1 μg/L, whereas 63.8% and 50.5%, respectively, had urinary cotinine concentrations above the level of detection (LOD) of 0.5 μg/L. Median unadjusted and creatinine adjusted urinary concentrations of cotinine in pregnant women were 0.7 μg/L, and 0.9 μg/g creatinine, respectively, and in newborn infants were 0.5 μg/L, and 1.3 μg/g creatinine, respectively. We did not find an association between maternal and infant urinary cotinine level. Maternal (but not infant) urinary cotinine was significantly associated with paternal smoking (p < 0.05). Infant (but not maternal) cotinine above the LOQ was negatively associated with birth weight (p < 0.05).Conclusions: In this high socioeconomic cohort, almost a third of newborn infants born to non-smoking mothers had quantifiable levels of urinary cotinine. This is the first study showing that newborns with quantifiable urinary cotinine levels have lower birth weight. [ABSTRACT FROM AUTHOR]

Introduction: Maternal urinary levels of dialkyl phosphate (DAP) metabolites of organophosphate pesticides (OP) during pregnancy are associated with adverse outcomes in the offspring. Between 2012 and 2014, eighteen active OP ingredients were restricted or banned in Israel for agricultural use.Aim: We aimed to study trends of urinary DAP metabolites among pregnant women and their offspring in the era of the new regulations.Methods: Pregnant women were recruited at 11-18 weeks of gestation and provided spot urine samples (n = 273). Soon after birth, neonatal urine samples were collected (n = 107). All urine specimens analyzed for DAP metabolites. Trends in DAP metabolites were tested using Mann-Kendall trend statistic (M-K S) and linear regression models were constructed to estimate the association between calendar period and DAP levels between September 2012 and March 2016.Results: Over the study period, median maternal ∑DAP levels decreased from 248 nmol/L to 148 nmol/L. Time of recruitment was associated with a statistically significant decrease in DAP metabolites, which remained significant after multivariate adjustment. Overall, the results for the analysis of before and after June 2014 showed a significant decrease in ∑DAP of -0.198 log10 nmol/L (95%CI: -0.311,-0.084) which corresponds with a decrease of 36.6% in ∑DAP. A similar trend was found for DAP metabolites in neonatal urine. Compared to other studies, pregnant women in Jerusalem had higher ∑DAP levels, even at the end of the study period.Conclusion: We observed significant reductions in maternal and neonatal DAP urinary levels during the period of 2012-2016. Regulations restricting agricultural use of OP seem to be effective in reducing population exposure to OP, in an era when residential use of OP is banned. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the impact of menopause, age, and women's symptoms and characteristics on quality of midlife., Methods: This was a cross-sectional study of 151 healthy women aged 45 to 55 years attending university-affiliated menopause clinics. To obtain the data, a questionnaire designed by the investigators and based on the Greene Climacteric Scale and the Utian Menopause-Specific Quality of Life scale was self-completed by the participants., Results: A significant gradual increase in the total Greene Climacteric Scale score was observed from premenopausal to perimenopausal and postmenopausal women (P = 0.02), specifically in the vasomotor and sexual subscores (P < 0.0001 and P = 0.001, respectively). In contrast, the total quality-of-life score remained stable in every specific aspect (occupation, health, emotion, and sex) throughout the menopausal transition (P = 0.8). A significant correlation was found between the psychological, somatic, and sexual Greene Climacteric Scale subscores and the Utian quality-of-life score (r = -0.46, P < 0.001; r = -0.29, P < 0.05; r = -0.28, P < 0.05, respectively), whereas the vasomotor subscore had no impact on midlife quality. The number of children was the only demographic factor that had a significant impact on the Utian score (P < 0.05) and to a higher extent than the climacteric syndrome. Hormone therapy equalizes the climacteric symptom profile of users to that of nonusers, yet both users and nonusers reported similar scores of midlife quality., Conclusions: Menopause-specific quality of life may be affected by both demographic and climacteric parameters. Menopausal symptoms, but not vasomotor symptoms, have a negative impact on midlife quality, yet to a lesser degree than does the number of children.

Objective: To study whether the sex of the offspring is related to increasing parental age, gravidity, and parity, hypothesizing an altered male-to-female sex ratio with the advancing parental age., Design: A large retrospective cohort study., Setting: The study analyzed birth records of Hadassah Hebrew University Medical Center in Jerusalem from June 2003 to December 2006., Patient(s): 35,837 birth records were analyzed including 941 multifetal deliveries, excluding foreign inhabitants (n = 744), missing data for the main study outcome (n = 2) and parturients over 50 years to control for egg donation (n = 26)., Intervention(s): None., Main Outcome Measure(s): Male-to-female sex ratio., Result(s): The male-to-female sex ratio of all the newborns was 1.05. This ratio did not change significantly with either maternal or paternal age. Neither gravidity nor parity affected the male-to-female ratio. The only factor that affected the regression of sex ratio was the length of gestation., Conclusion(s): Sex ratio at birth is remarkably constant. No association was found between parental age or birth order and neonatal sex ratio., (Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)