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The Swan Study

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Introduction

The SWAN Repository is the biologic specimen bank of the Study of Women's Health Across the Nation (SWAN). SWAN is a National Institutes of Health funded, multi-site, longitudinal study of the natural history of the midlife including the menopausal transition. The overall goal of SWAN is to describe the chronology of the biological and psychosocial characteristics that occur during midlife and the menopausal transition. In addition, SWAN is describing the effect of the transition and its associated characteristics on subsequent health and risk factors for age related chronic diseases.

SWAN was designed to collect and analyze information on demographics, health and social characteristics, reproductive history, pre-existing illness, physical activity, and health practices of mid-life women in multi-ethnic, community-based samples; elucidate factors that differentiate "symptomatic" from asymptomatic women during the menopausal transition; identify and utilize appropriate markers of the aging of the ovarian-hypothalamo-pituitary axis and relate these markers to alterations in menstrual cycle characteristics as women approach and traverse the menopause; and elucidate factors that differentiate women most susceptible to long-term pathophysiological consequences of ovarian hormone deficiency from those who are protected. 

The biological specimen bank can also be linked by identification number (not by participant name) to data collected in the Core SWAN protocol. The specimen bank can also be linked with data from the Daily Hormone Study as well as menstrual calendars. Types of data include:  epidemiological data, psychosocial data, physical measures, as well as data from assays (endocrine and cardiovascular information).

Population

SWAN has seven clinical study sites located in six states, two in California, and one each in Illinois, Massachusetts, Michigan, New Jersey and Pennsylvania. The SWAN cohort was recruited in 1996/7 and consists of 3302 African American, Caucasian, Chinese American, Hispanic and Japanese American women.  Cohort members complete an annual clinic visit.

SWAN I and II (1994-2003) and SWAN III (4/1/2004-3/31/2009)

A major focus of the SWAN investigators has been cohort retention.  This has resulted in 2617 (79.3%) of the original 3302 women returning for the 5 year clinic visit.  The table below presents the distribution of visit status at follow-up visits 01 through 05, by ethnicity and for all ethnic groups combined.  The high participation enhances the value of specimens available through the Repository. 

SWAN Retention Rate

a) Percentage of baseline cohort for specific ethnic group and b) Percentage of total baseline cohort 

Core Repository: Types of Specimens 

As of January, the Core Repository included approximately 510,000 samples from the first 7 years of specimen collection.  This included more than 300,000 samples from the annual visits and 206,000 samples from the Daily Hormone Sub-study (DHS). 

As seen in the following table below, during a Annual visit, participants provide materials for up to 24-28 aliquots to be incorporated into the Repository.  During a DHS visit, a participant provides 6 serum samples and between ~30-50 urine samples depending upon the length of her menstrual cycle. 

Core Sample Contributions to the Repository

DHS participants (887) provide urine samples collected throughout one menstrual cycle each year.  A typical DHS collection consists of a blood draw plus collection of 10 ml of urine daily throughout the month-long menstrual cycle, up to 50 days.  DHS Repository samples consist of 6 serum samples and 30 5 ml urine samples.  Specimen collection occurs from the time of menstrual bleed to the subsequent menstrual bleed or up to 50 days, whichever come first.  The current DHS collection consists of more than 200,000 specimens stored in 5 ml vials.  Additionally, there are a portion of DHS urine samples that were assayed by the CLASS lab prior to submission into the repository. These samples have undergone at least one thaw/refreeze cycle. The volume for DHS urine samples is 5 ml. Presently, all H1 DHS urine samples have been aliquoted to 0.5 ml and the repository is in the process of aliquoting DHS urine samples for all subsequent years, where a participant has contributed DHS urine samples for at least four consecutive years.   

To access the most recent sample inventory information please  click here.

DNA Repository: Types of Specimens

The SWAN DNA Repository currently contains extracted diluted DNA from 1538 SWAN participants.  B-lymphocytes were transformed with Epstein Barr virus, and the resulting transformed b-cells aliquoted.  Information about using these transformed cells for genomic or proteomic studies is available. 

 DNA has been extracted from one aliquot (per woman) of the immortalized cells using the Puregene system.  There was an average DNA yield of 217.0 mg/mL and a A₂₆₀/A₂₈₀ average ratio of 1.86.  This DNA, in turn, has been aliquoted into 20ng/1 ml units for release by the DNA Repository. 

Samples are free of personal identifiers and collected under consents that allow a broad range of activities related to women's health.  To access the most recent DNA sample inventory information please click below.

Extracted DNA Graph  - This graph shows the number of extracted DNA samples currently in the repository inventory.  DNA has been extracted from one aliquot (per woman) of the immortalized cells using the Puregene system.  There was an average DNA yield of 217.0 g/mL and a A₂₆₀/A₂₈₀ average ratio of 1.86.  This graph also includes the count of DNA samples that have been aliquoted into 20ng/1 ml units (diluted samples).  Click anywhere on the graph to access this data in table format.

All of these samples are available to researchers who wish to study the midlife and menopausal transition.  Scientists who use these specimens can also request data collected during a participants annual visit including medical and health history, psychosocial measures, biological measures and anthropometry.

 To learn more about the SWAN study, the SWAN Repository and how to apply to use SWAN Repository Specimens, click the appropriate link on the left side of this page.