John Wingerd

Serum high-density-lipoprotein cholesterol in women using oral contraceptives estrogens and progestins.

To determine the associations between high-density-lipoprotein cholesterol levels and use of oral contraceptives or of noncontraceptive estrogens and progestins we analyzed the serum levels of this lipid in 4978 women, 21 to 62 years of age. In estrogen users, the mean level was 6.7 to 15.1 mg per deciliter above the nonuser level (P less than 0.001), whereas in a group of progestin users it was 15.8 mg per deciliter below (P less than 0.001). In women using combination oral contraceptives, the level varied with the type and dose of the component steroids, in general increasing with increasing dose of estrogen and decreasing with increasing dose or potency of progestin. Thus, the net effect of use of a combination oral contraceptive on high-density-lipoprotein cholesterol depends on its formulation.

USE OF ORAL CONTRACEPTIVES, CIGARETTE SMOKING, AND RISK OF SUBARACHNOID HÆMORRHAGE

In a large cohort of women, the risk of subarachnoid haemorrhage was significantly associated both with cigarette smoking and with use of oral contraceptives (O.C.S.). The risk of cigarette smokers was 5.7 times that of non-smokers; for current users of O.C.S. the risk was 6.5 times that of non-users. The risk in women who both smoked cigarettes and used O.C.S was 22 times that of women who neither smoked nor used O.C.S. Past use of O.C.S was also significantly associated with increased risk of subarachnoid haemorrhage, the relative risk being 5.3. There was some evidence that risk may increase with duration of O.C. use. In this series no significant associations were found between occurrence of subarachnoid haemorrhage and history of hypertension or of migraine headache.

Placental ratio in white and black women: Relation to smoking and anemia

In a study of 7,000 pregnancies it was found that, particularly in black women, hemoglobin levels were lower in smokers than in nonsmokers. This is the reverse of previously reported findings in nonpregnant persons. At delivery, the mean ratio of placental weight to birth weight (placental ratio) was higher in the infants of smokers than of nonsmokers. This observation is discussed in the light of reported elevated placental ratios at high altitudes or after severe anemia of pregnancy. The relationships are complex, and are not uniform with respect to ethnic group.