Pre-pregnancy body mass index, maternal weight gain during pregnancy and risk of small-for-gestational age birth: results from a case-control study in Italy.

OBJECTIVE: To analyze the association between body mass index (BMI), gestational weight gain (GWG), and risk of small for gestational age (SGA) birth. METHODS: Case-control study: cases included 555 women (mean age 31 years) who delivered SGA babies in two Italian clinics. Controls included women who gave birth at term to healthy infants of normal weight at the hospitals where cases had been identified. RESULTS: Underweight women were at risk of delivering SGA babies (odds ratio, OR, 1.9, 95% confidence interval, CI, 1.6-2.4) and overweight women had a not significant lower risk (OR 0.7, 95% CI 0.5-1.0). The risk of delivering an SGA baby was higher also for women with less than recommended GWG (OR 1.4, 95% CI 1.1-1.9), whereas gaining more than recommended weight was not significantly protective (OR 0.7, 95% CI 0.5-1.0). The analysis in strata of BMI showed that GWG played a significant role, whereas in strata of GWG pre-pregnancy BMI seemed less important. CONCLUSION: These results suggest that achieving the adequate weight gain during pregnancy, as recommended by IOM, protects against the risk of delivering an SGA infant also in underweight women.

Survival and prognostic factors of women with advanced ovarian cancer and complete response after a carboplatin-paclitaxel chemotherapy.

OBJECTIVE: We evaluated the characteristics and determinants of 5-year survival in ovarian cancer patients with complete response after first line treatment who entered a randomised study comparing two different chemotherapeutic schedules. METHODS: This analysis included 232 ovarian cancer patients with complete response after first line surgery and chemotherapy coming from a large randomised trial comparing the effect of different doses of paclitaxel combined with fixed doses of carboplatin. RESULTS: The 5-year overall survival in patients was 57.3%. The difference in 5-year survival for age <52 years (65.1%), 53-62 (51.4%) and > or = 63 (51.2%) was statistically significant (P = 0.048). The 5-year overall survival rates were 64.6% for stage III and 57.9% for stage IV. Serous and clear cell histotypes had a worse 5-year overall survival (51.5% and 50.8% respectively), while the endometrioid and mucinous had 67.1% and 71.4%: these differences were statistically different (P = 0.04). Women with residual tumour of 1 cm or smaller after primary surgery had better 5-year survival rates: 71.2% for patients with residual tumour < or = 1 cm and 46.9% for residual tumour >1 cm: these differences were statistically significant (P < 0.006). CONCLUSION: This study shows that in women with ovarian cancer and complete response after first line surgery and chemotherapy, age, histotype and residual tumour after surgery are determinants of 5-year overall survival.

Paclitaxel 175 or 225 mg per meters squared with carboplatin in advanced ovarian cancer: a randomized trial.

PURPOSE: To analyze the effect of different doses of paclitaxel with fixed doses of carboplatin in the treatment of ovarian cancer. PATIENTS AND METHODS: Patients with histologically confirmed epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stages IIB to IV, were eligible for this randomized, multicenter study. Women were randomly assigned to treatment with (1) carboplatin at the dose (in milligrams) corresponding to the following formula: target area under the free carboplatin plasma concentration versus time curve (AUC) = 6 x (glomerular filtration rate + 25) mg/m(2) (AUC6) plus paclitaxel 175 mg/m(2) for six cycles every 21 days or (2) carboplatin AUC6 plus paclitaxel 225 mg/m(2) for six cycles every 21 days. A total of 502 women entered the study. RESULTS: Pathologic complete response was documented in 132 patients (63.8%) in the 175 mg/m(2) group and in 127 cases (55.7%) in the 225 mg/m(2) group (chi(2) P =.090). The 4-year progression-free survival rate was 41.5% (SE = 3.5) in the 175-mg group and 39.2% (SE = 3.5) in the 225-mg group. The corresponding 4-year survival rates were 46.2% (based on 115 deaths) and 47.3% (based on 113 deaths), respectively. CONCLUSION: This randomized trial suggests that paclitaxel 175 mg/m(2) plus carboplatin AUC6 is the schedule with a more favorable profile than paclitaxel 225 mg/m(2) plus carboplatin AUC6.