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Background. Although there is a basis for linking pituitary or ovarian hormones with experimentally induced ovarian cancer, establishing their role in women is complicated because the usual case-control methods cannot be applied. In this study, hormonal levels women with a family history of ovarian cancer (FOC) and who are at higher risk for the disease are compared with women without such a history. Methods. The authors studied 106 unrelated women (FOC patients) with at least one primary or two second-degree relatives with ovarian cancer compared with 116 age- and residence-matched controls without a family history of ovarian cancer (FOC control subjects). All women were premenopausal, between the ages of 25 and 49 years, not currently using oral contraceptives, and had blood drawn during the early follicular phase for gonadotropins, estradiol ([E.sub.2]) and CA-125. Results. Women with a family history of ovarian cancer and control subjects did not differ significantly in follicle stimulating hormone (FSH) levels, [E.sub.2], or CA-125. Patients with a family history of ovarian cancer had significantly lower luteinizing hormone (LH) levels compared with control subjects and produced more and FSH relative to their level of LH. The ratios of LH to [E.sub.2] and LH to FSH were correlated with the enzymatic activity of galactose-1-phosphate uridyl transferase, which was shown previously to differ between FOC patients and control subjects. Conclusion. Lower LH and higher [E.sub.2] are reported in women with breast, endometrial, and ovarian cancer (before surgery). The authors speculate that these observations reflect greater LH binding and estradiol production in ovaries at risk for these cancers--the ovarian cortical hyperplasia postulated in older gynecologic literature as the precursor to estrogen dependent neoplasia. Cancer 1994; 74:1318-22. Key words: ovarian cancer, gonadotropins, CA 125, familial, estradiol, galactose-1-phosphate uridyltransferase.

OBJECTIVE: The purpose of this study was to determine whether reproductive antigens stimulate lymphocytes and macrophages from women with recurrent abortion to secrete factors that are toxic to preimplantation embryos or trophoblast cells in vitro. STUDY DESIGN: Mononuclear cells were isolated from 30 fertile controls and 300 nonpregnant women being evaluated for recurrent abortion. Supernatants generated from these cells after separate culture with sperm and trophoblast antigen extracts were added to two-cell mouse embryo cultures and trophoblast proliferation assays. Toxicity was assumed when the median percentage of embryos developing to blastocysts or trophoblast proliferation was [is less than or equal to] 50% of control values. Both parametric and nonparametric statistical methods were used where appropriate. RESULTS: Mouse embryo development and/or trophoblast proliferation were significantly inhibited by supernatants from trophoblast and/or sperm antigen-activated peripheral blood leukocyte cultures from a majority of 300 women with recurrent abortion but not from 30 women with normal reproductive histories. The mouse blastocyst development assay was more sensitive than the trophoblast proliferation assay in determining toxic factor production. Embryo-toxic factors were produced by activated leukocyte cultures from 90% of 180 women with a history of recurrent abortion of unexplained etiology, whereas trophoblast-inhibitory factors were detected in 50% of women from the same group. The embryo-toxic factor(s) was heat labile, had a molecular weight(s) between 10 and 30 kd, and was absorbed out by passage through affinity columns containing anti-interferon gamma beads. CONCLUSION: We conclude that recurrent abortion in some women is associated with embryo-and/or trophoblast-toxic factor production in response to stimulation by sperm or trophoblast antigens and that the principal factor may involve the 18 kd, heat-labile, T-lymphocyte cytokine interferon gamma. This study suggests a new cause of recurrent abortion. (Am J Obstet Gynecol 1992;166:1044-52.)

Approximately 9 percent of single live births in the US occur prematurely, of which two thirds occur spontaneously. Premature infants are at increased risk for neonatal diseases and death. This study examined risk factors associated with spontaneous premature births. A number of characteristics of 140 women who gave birth prematurely and spontaneously were compared with those of 140 women, matched for age and date of delivery, who gave birth spontaneously at term. More of the women who gave birth prematurely were nonwhite, single, and had completed less than 12 years of schooling. When these demographic variables were controlled for, women who had a history of induced abortion were slightly more likely to deliver prematurely. Women who had previously delivered prematurely were significantly more likely to have delivered prematurely in this group of deliveries. Smoking was also associated with an increased risk for delivering prematurely. Even when smoking was controlled for, women who were underweight were more likely to deliver prematurely. Maternal exposure to diethylstilbestrol (DES) was also associated with an increased risk for delivering prematurely. The results indicated a number of factors associated with an increased risk of delivering prematurely. (Consumer Summary produced by Reliance Medical Information, Inc.)

Up to 25 percent of clinically recognized pregnancies end in a spontaneous (natural) abortion. Once a fetal heartbeat is detected, the risk of spontaneous abortion decreases dramatically, occurring in only 2 to 4 percent of pregnancies. It is not clear whether there are indicators of a possible spontaneous abortion once the heartbeat has been established. Some evidence exists that a small embryonic sac size during the first trimester of pregnancy, even when the fetal heartbeat is present, indicates a higher risk of spontaneous abortion. This study followed 17 pregnancies in which a fetal heartbeat was present but so was a small sac during the first trimester. A group of 52 pregnancies where sac size was normal was also followed for purposes of control. A small sac size was determined to be a difference between mean sac size (MSS) and crown-rump lengths (CR) of less than 5 mm. Results found that in the small sac group, spontaneous abortion occurred in 15 of the 16 pregnancies (94 percent) compared with 4 of 52 (8 percent) in the control group. These results indicate that once a fetal heartbeat has been established, a small sac size during the first trimester is a good indicator of a probable poor outcome of the pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)