[show abstract][hide abstract] ABSTRACT: Racial disparities in pregnancy outcome in the United States are significant, persistent and costly, but the causes are poorly understood. We propose that disproportionate exposure of African-American women to environmental endocrine disrupting compounds (EDCs) may contribute to birth outcome disparities. Marked racial segregation, as well as health behaviors associated with poverty could result in differences in exposure to particular EDCs. One EDC that has aroused concern in recent years is bisphenol-A (BPA), a widely used industrial plasticizer with known estrogenic properties. Published studies indicate that excessive BPA exposure is associated with reduced fetal survival, as well as reductions in maternal weight and fetal body weight. Related findings include adverse effects of BPA exposure on ovarian function, mammary gland development, earlier age of puberty onset and some metabolic parameters. However, these findings are largely limited to experimental animal studies, and need to be validated in human populations. Our review supports the need to move beyond the currently dominant toxicological approach to examining the effects of BPA exposure, and rely more on observational human studies and epidemiological methods. Many of the risk factors for racial disparities in pregnancy outcome are global or difficult to modify, but exposure to BPA is a potentially malleable risk factor. If BPA contributes to racial disparities in pregnancy outcome, there are important implications for prevention. It is our hope that this review will stimulate further research in this important and neglected area.
Journal of perinatology: official journal of the California Perinatal Association 08/2009; 30(1):2-9. · 1.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: Disorders of pubertal timing are common and challenging problems for pediatric endocrinologists. Early or late puberty can have immediate effects on a child's psychosocial well-being and may have long-term effects on adult stature. Much is known about the regulation of the hypothalamic-pituitary-gonadal axis, but the triggers of pubertal onset in the general population remain elusive. This article reviews recent data suggesting a possible shift in the age of pubertal onset; current knowledge regarding factors that regulate the onset of puberty; and the etiologies, diagnosis, and treatment of precocious and delayed puberty.
Endocrinology & Metabolism Clinics of North America 10/2005; 34(3):617-41, ix. · 3.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: The most significant corporal change observed in adolescent girls is the onset of menstruation, which occurs between 12 and 13 years of age. In several cases, described with the term 'precocious puberty', pubertal development can begin at a significantly younger age. The term 'delayed puberty' refers to absence of pubertal development in a girl over the age of 14. Amenorrhoea can occur due to a broad spectrum of causes, such as anatomic deficiencies of the reproductive tract and hormonal disorders. Hypogonadotrophic hypogonadism, which implies a permanent malfunction in gonadotrophin secretion; hypergonadotrophic hypogonadism, which involves poor ovarian response in gonadotrophin stimulation; and hyperprolactinaemia can also lead to amenorrhoea. Significant amount of stress on the adolescent girl can cause hypothalamic dysfunction, leading to a situation called 'hypothalamic amenorrhoea'. Abnormal uterine bleeding (AUB), and especially the subtype of dysfunctional uterine bleeding (DUB), is the most urgent gynaecological problem during adolescence, while dysmenorrhoea (also referred to as painful menstruation) is the most frequent problem for which adolescents and their parents refer to a physician.
Best practice & research. Clinical obstetrics & gynaecology 04/2010; 24(2):157-71. · 1.87 Impact Factor
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