International Journal of Women's Health最新文献

Purpose: Bonding refers to the development of an emotional relationship between a mother and her baby, which forms a strong and continuous bond that provides the baby with a sense of security and plays an important role in its mental well-being throughout life. The objective of this study was to assess the relationship between cognitive distortions, attitudes towards motherhood and postpartum depression, which have not been studied before, as well as to elucidate their impact on the mother-infant bonding process.

Patients and methods: The sample of the study was created between November 2018- June 2019 using the non-discriminatory multiplicity snowball sampling technique through social media. Women with infants aged 0-1 year residing in Turkey were asked to participate in the online survey. A sociodemographic data form, the Edinburgh Postpartum Depression Scale, Attitudes Towards Motherhood Scale (AToM), Postpartum Bonding Questionnaire (PBQ), and Cognitive Distortions Scale (CDS) were applied to the sample via social media.

Results: The study sample consisted of 387 women with infants aged 0-1 years, and the rate of impairment bonding was found to be 11.4%. CDS, ATOM and depression scores were significantly higher in the impaired attached group (p < 0.05). The findings indicated that an individual with a psychiatric diagnosis was 2.653 times more likely to exhibit impaired bonding (OR: 2.653, 95% CI: [1.08-6.517]; p = 0.033), and those with a higher AToM score were 1.044 times more likely to display impaired bonding (OR: 1.044, 95% CI: [1.013-1.075]; p = 0.004).

Conclusion: The cognitive structure of the mother is associated with impaired mother-baby bonding. Eliminating the mentioned cognitive elements with psychotherapy interventions will be protective in terms of impaired bonding related to psychopathologies and/or interpersonal relationship problems.

Purpose: Coronary heart disease (CHD) is the most common cardiovascular disease leading to global mortality and is a major contributor to disability. As CHD is the main cause of death among women, early prediction of the risk of coronary heart disease would be useful. The Framingham risk score, waist-height ratio, and heart rate recovery have been used to predict CHD risk. The Framingham risk score is used to evaluate 10-year absolute risk of developing CHD. Waist Height Ratio is useful for early detection of the risk of heart disease in Malaysia, where obesity and metabolic syndrome are common across various demographics, because it is a reliable indicator of abdominal fat distribution. Heart Rate Recovery is a useful non-invasive method for early assessment of heart disease risk, featuring simplicity and the ability to represent both cardiovascular fitness and autonomic nervous system function. However, no study has compared waist-height ratio and heart-rate recovery as effective methods for predicting coronary heart disease. There is an increasing trend of CHD in Malaysia, particularly among females. Therefore, this study aimed to compare the effectiveness of waist-height ratio and heart-rate recovery in predicting the risk of coronary heart disease among working Malaysian women.

Methods: This is a cross-sectional study. Data on the Framingham risk score, waist-height measurement, and the 6-minute walk test (heart-rate recovery) were collected from 134 working women.

Results: The mean age of the participants was 39.13 ± 7.06 years. The results showed that the waist-to-height ratio had a weak but significant correlation with Framingham risk score (r = 0.18). However, heart rate recovery showed a negative correlation (r = -0.029) with the Framingham risk score.

Conclusion: The waist-height ratio is considered a more effective risk assessment method than heart-rate recovery for identifying the risk of coronary heart disease in working Malaysian women.

Background: Hepatic angiosarcoma is an extremely rare, uncontrollable tumor with strong invasion, high mortality rate, and extremely poor prognosis. There is first report on hepatic angiosarcoma accompanied by eosinophilia.

Case presentation: A woman with a chief complaint of poor appetite for about 3 months presented to a local hospital with a liver mass. Laboratory examination revealed a significant increase in eosinophils count was 9.58% in the serum. Abdominal MRI revealed multiple focal high-density lesions in the liver and spleen, and cranial MRI revealed multiple high-density shadows in the skull. Laparoscopic biopsy revealed a hepatic angiosarcoma and targeted treatment with Anlotinib was performed. Two months later, the patient died of splenic rupture and bleeding.

Conclusion: Hepatic angiosarcoma often has no specific clinical manifestations, and we found that this case can lead to an increase in eosinophils, which is worth the attention of clinical physicians.

Objective: We sought to study the expression of FGFR2 and c-Met and evaluate the correlation between the two proteins in a series of endometrial cancer patients as well as the prognostic significance of the two markers in endometrium carcinoma.

Methods: Patients who were diagnosed with endometrial cancer and had undergone surgical treatment in Beijing Chao-Yang Hospital, Capital Medical University from November 2004 to June 2011 were included in this study. Tissue microarray construction, immunohistochemical staining and scoring were employed to study the expression of FGFR2 and c-Met. SPSS version 22.0 was used to evaluate the correlation between FGFR2 and c-Met expression and the prognosis prediction value of the two markers.

Results: In total, 109 patients were included in this study. The median age was 56 years (ranges, 30-79). The most common histologic tumor subtype was adenocarcinoma (86.2%). The five-year survival rate was 87.2%. Significantly different FGFR2 expression was observed among patients with different disease stages (p < 0.001), depths of myometrial invasion (p = 0.001) and lymph node status (p < 0.001). C-Met expression was also increased in tissues from patients with advanced stage disease, deep myometrial invasion and lymph node metastasis (p < 0.001, p = 0.031 and p < 0.001, respectively). The expression of FGFR2 and c-Met was increased in the group with poorer prognosis (overall survival < 5 years) (p = 0.002 and p = 0.023, respectively). Moreover, a strong positive correlation was observed between FGFR2 and c-Met expression (p < 0.01, r = 0.656). FGFR2 was a significant factor that influence the FIGO stage.

Conclusion: Higher expression of FGFR2 and c-Met is associated with more advanced stage, deeper myometrial invasion and lymph node metastasis in endometrial cancer and poorer prognosis. In addition, high expression of FGFR2 is correlated with high c-Met expression.

Objective: To investigate the levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-1 receptor (IGF-1R) in the serum and placenta of patients with preeclampsia (PE), establish their correlations, and evaluate their diagnostic potential.

Methods: 22 PE patients and 22 normal pregnant women who underwent cesarean section deliveries at the First Affiliated Hospital of Guangxi Medical University between December 2021 and December 2022 were included in the observation group and the control group. Enzyme-linked immunosorbent assay (ELISA) was utilized to measure the levels of IGF-1 and IGF-1R in serum samples, and immunohistochemical techniques (IHC) were employed to evaluate the levels of IGF-1 and IGF-1R in placental samples. The association between IGF-1, IGF-1R, and PE was analyzed, and the diagnostic accuracy of serum IGF-1 and IGF-1R for PE was assessed by ROC curve analysis.

Results: The levels of IGF-1 and IGF-1R in the serum and average optical density (AOD) value of IGF-1 and IGF-1R in placental tissue of the observation group were significantly lower. In the group with PE, there was a reduction in the number of positive cells for IGF-1 and IGF-1R in placental tissue. Positive correlations were noted between IGF-1 and IGF-1R levels in both serum and placental tissue and neonatal birth weight. The ROC curve analysis revealed that serum IGF-1 exhibited an AUC of 0.944 for diagnosing PE, with a sensitivity of 86.00% and specificity of 100.00%. Serum IGF-1R showed an AUC of 0.820 for diagnosing PE, with a sensitivity of 77.00% and specificity of 77.00%.

Conclusion: The expression of IGF-1 and IGF-1R in the serum and placental tissues of preeclamptic pregnant women was significantly reduced. This reduction implies that IGF-1 and IGF-1R may potentially be used as biomarkers in the clinical prediction, diagnosis, and prognosis evaluation of PE.

Background: A growing number of patients with early-stage cervical cancer opt for local tumor resection to preserve the uterus. Nevertheless, there is still a dearth of long-term comparisons between local tumor destruction/excision (LTD/LTE) and total hysterectomy(TH), and the optimal target population for local tumor excision remains uncertain.

Methods: A multicenter retrospective study utilizing the Surveillance, Epidemiology, and End Results (SEER) database to compare the long-term outcomes between LTD/LTE and TH in stage IA cervical cancer patients was conducted. A 1:1 propensity score matching (PSM) method was employed to obtain matched cohorts with similar baseline characteristics in the LTD/LTE and TH groups. Kaplan-Meier analysis was used to compare overall survival (OS) and cancer-specific survival (CSS) between the two groups. The Cox proportional hazard models were employed to identify factors associated with OS and CSS.

Results: This study comprised a total of 6382 cervical cancer patients, with 1759 undergoing LTD/LTE and 4623 undergoing TH. After PSM, a significant difference was observed in OS (P=0.030) between the two groups, while no significant difference was found in CSS (P=0.110). Subgroup analysis of patients with stage IA1 (OS: P=0.018; CSS: P=0.230) and IA2 (OS: P=0.071; CSS: P=0.240) revealed no significant differences in OS and CSS between the two groups. Older age (≥50 years) [HR=2.20; 95% CI: 2.20-3.30)] and histological types other than squamous cell carcinoma and usual-type adenocarcinoma [HR=4.40; 95% CI:1.80-11.10] favored TH for better OS, whereas well-differentiated (grade I-II) [HR=0.40; 95% CI: 0.20-0.90] patients were more suitable for LTD/LTE, leading to improved OS and CSS outcomes.

Conclusion: It was determined that the long-term outcomes of LTD/LTE are comparable to TH and can serve as a safe option for selected patients with stage IA cervical cancer. Future large prospective studies are required to validate our findings and explore differences in recurrence patterns between the two treatment strategies.

Introduction: Postpartum anemia (PPA) occurs when hemoglobin (Hb) levels drop below 11 g/dl within 42 days after childbirth. This growing public health issue is a leading cause of complications that can affect maternal health and increase the risk of morbidity and mortality. However, evidence about its prevalence and associated risk factors is still unclear.

Purpose: This study aimed to determine the incidence of PPA, potential risk factors associated with its occurrence, and severity in two major hospitals in Najran, Saudi Arabia.

Patients and methods: A retrospective observational study was performed among postpartum women admitted to the Maternity and Children Hospital and the Obstetrics and Gynecology Clinic at the Najran University Hospital. The data was collected from electronic medical records from November 2023 to March 2024, including the patient's characteristics, like nationality, body mass index (BMI), education level, employment status, medical history, delivery details, laboratory results, and anemia diagnosis. Statistical analysis was conducted using IBM SPSS software, with significance defined as p-values below 0.05.

Results: A total of 565 postpartum women were included. The prevalence of PPA was 52.7%. Anemic participants prior to labor were significantly 4.986 times more likely to experience postpartum anemia compared to non-anemic participants, with a 95% confidence interval of (1.842-13.496) and a p-value of 0.002. The risk factors regarding the severity of anemia were significantly high among participants with childbirth complications (79.2%), one parity (67.2%), and prepartum anemia (72.6%).

Conclusion: This study highlights a significant prevalence of postpartum anemia among women, strongly linked to anemia prior to labor. The severity of postpartum anemia is particularly greater in women with childbirth complications, those who have had one previous birth, or who were anemic before delivery. Comprehensive postpartum follow-up for changes to improve access to prenatal and postnatal care are essential strategies to reduce postpartum anemia and enhance maternal health outcomes.

Objective: To investigate the relationship between the progesterone level on trigger day (P_trigger) to basal progesterone (bP) ratio and the outcomes of in vitro fertilization-embryo transfer (IVF-ET).

Methods: A retrospective analysis was conducted on women who received an antagonist protocol, with a P_trigger less than 1.5 ng/mL and who underwent fresh embryo transfer. Based on the P_trigger/bP ratio, participants were categorized into four groups: group A (P_trigger/bP < 1, n = 284), group B (P_trigger/bP ≥ 1 and < 2, n = 363), group C (P_trigger/bP ≥ 2 and < 3, n = 165), and group D (P_trigger/bP ≥ 3, n = 118). Recombinant follicle-stimulating hormone was used to stimulate ovulation. Receiver operating characteristic curve analysis was used to analyze the accuracy of the P_trigger/bP ratio in predicting clinical pregnancy following fresh embryo transfer.

Results: A decreasing trend in bP levels was observed across groups (A > B > C > D), while P_trigger levels showed an increasing trend (A < B < C < D). Groups A and B included significantly younger women and required lower doses of gonadotropin (Gn) compared to Groups C and D. The embryo implantation and clinical pregnancy rates in Group A were 34.93% and 49.30%, respectively, significantly higher than those in Group D (23.19% and 33.90%, respectively). After propensity score matching for age, the differences in implantation and clinical pregnancy rates were not statistically significant between Group A and D. The P_trigger/bP ratio had limited accuracy in predicting clinical pregnancy, with an area under the curve of 0.538 (95% CI [confidence interval]: 0.501-0.575, P = 0.044).

Conclusion: A P_trigger/bP ratio of less than 1 was associated with relatively favorable pregnancy outcomes in women undergoing IVF-ET with an antagonist protocol for ovulation induction.