Ecological study of effects of industrial watershed on Müllerian anomalies in an obstetric population

Müllerian Duct Anomalies and Anti-Müllerian Hormone Levels in Women With Polycystic Ovary Syndrome

BACKGROUND

Significant associations between the presence of polycystic ovary syndrome (PCOS) and uterine anomalies have been reported. It is unclear whether high anti-Müllerian hormone (AMH) levels coexist with the development of uterine malformations in women with PCOS. This study sought to investigate the association between Müllerian duct anomalies and anti-Müllerian hormone (AMH) levels in women with PCOS.

METHODS

In this retrospective cohort study, the records of 1,391 women with PCOS were analyzed. The cohort was divided into a low-AMH group (n = 700) and a high-AMH group (n = 691), based on an AMH cutoff value of 8.45 ng/ml. Müllerian duct anomalies were classified into four subtypes based on three-dimensional ultrasonography: septate uterus, bicornuate uterus, uterus didelphys, unicornuate uterus, and arcuate uterus. The primary outcome was the overall incidence of Müllerian duct anomalies. The secondary outcome was the prevalence of the abovementioned specific types of Müllerian duct anomalies. The prevalence of Müllerian duct anomalies was analyzed using the chi-squared test or Fisher's exact test.

RESULTS

Among the patients with PCOS, the prevalence of unicornuate uterus anomalies was higher in the high-AMH group than in the low-AMH group (1.0% vs. 0.1%, P = 0.04). No statistically significant difference in the overall incidence of uterine malformations was found between the two AMH groups (4.3% vs. 5.7%, P = 0.22).

CONCLUSIONS

Our study confirmed a higher prevalence of unicornuate uterus in PCOS women with high AMH levels. Clinicians might decide to investigate the possibility of a unicornuate uterus in PCOS women with high AMH levels.

Spatial Outcomes of Soft Tissue Sarcoma in Southern West Virginia

Introduction Dioxins, polychlorinated biphenyls (PCBs), and 2,3,7,8-Tetrachlorodibenzodioxin (TCDDs) are persistent organic pollutants widely distributed in the food chain. For over 50 years, the Monsanto plant in Nitro, West Virginia, created dioxin waste while producing herbicides, Agent Orange (during the Vietnam War), and different forms of rubber. Recent and past literature has established a link between the Monsanto plant and increased cancer cases within the region. Soft tissue sarcoma is one of the few specific cancers that has been linked to dioxin exposure. This pilot study examined whether sarcoma cases were clustered or randomly distributed within Kanawha County, West Virginia over the years 2000 to 2013. We hypothesize that sarcoma cancer cases will be spatially clustered. Methods This study assessed the spatial distribution of cancer patients with addresses within the Nitro, West Virginia, and study area. The Charleston Area Medical Center shared soft tissue sarcoma (n = 97) cases from 2000 to 2013. An unweighted K function with confidence intervals (99 Monte Carlo permutations) and 10 distance at 2800 meters each band analyzed the distribution of cases. Results The results suggest that sarcoma cases are slightly clustered within the study area. The region also has a high concentration of chemical and industrial sites. The eighth distance band exhibited the greatest difference (11384), between the expected versus the observed K function. Conclusion The unweighted K function shows non-random clustering. Future studies could investigate possible associations to industrial, chemical, or other possible point source contamination within the study area.