International Journal of Women's Health最新文献

Purpose: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study employed a multi-level comparative approach to assess the global, regional, and national burden of early-onset lung cancer (EOLC, diagnosed before age 50) from 1990 to 2021. This design enabled the identification of distinctive epidemiological patterns. Within this framework, the primary objective was to determine and characterize the specific burden of EOLC among young women in China. A secondary objective was to evaluate the corresponding burdens in young women globally and regionally to provide essential context for interpreting the findings from China.

Patients and methods: We used data from the Global Burden of Disease (GBD) 2021 to assess trends in EOLC incidence, mortality, disability-adjusted life years (DALYs), and attributable risk factors from 1990 to 2021. Analyses were conducted globally, regionally, and nationally for individuals under 50. Age-standardized incidence and mortality rates (ASIR and ASMR) were calculated, and Joinpoint regression was employed to evaluate temporal changes.

Results: In China, EOLC rates declined among men and the overall population but increased significantly among women beginning in 2015 (APC for incidence: +2.0%, 2015-2021). Attribution analysis showed that occupational exposures contributed an increasing share of EOLC deaths among Chinese women, rising from 7.37% in 1990 to 10.47% in 2021, compounded by persistent effects from secondhand smoke and air pollution-particularly particulate matter pollution, which accounted for 25.75% of deaths and 25.58% of DALYs in 2021. From 1990 to 2021, the global burden of EOLC remained substantial. While age-standardized incidence and mortality rates showed a declining trend, tobacco smoking persisted as the predominant risk factor, accounting for the largest proportion of attributable deaths. Marked disparities in this burden were observed across regions and between sexes.

Conclusion: The EOLC burden is shifting toward low- and middle-SDI regions. Within this transition, a distinct and rising burden among young women in China has emerged as a critical public health concern. These findings highlight the urgent need for targeted prevention strategies that address sex- and region-specific risk factors, particularly occupational and environmental exposures in rapidly developing settings.

Objective: Ectopic pregnancy (EP) is a significant global health concern and is associated with maternal mortality and compromised future fertility. This research aims to refine the assessment of EP's global impact and its associated inequalities.

Methods: EP's incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were analyzed using the data from the Global Burden of Disease study from 1990 to 2021. Decomposition analysis was performed to examine the roles of ageing, population growth, and epidemiological changes. Novel frontier and health inequality analyses (Slope Index of Inequality, Concentration Index) were conducted to evaluate socio-demographic disparities.

Results: From 1990 to 2021, the global age-standardized incidence rate (ASIR) decreased from 305.9 to 212.87 per 100,000. However, absolute DALYs increased from 288,083 to 396,856, with the highest burden shifting to the 20-24 age group. Health inequality analysis revealed a significant but narrowing absolute disparity (SII: -56.68 to -36.56), while frontier analysis identified sub-Saharan African nations with the largest unmet potential for health improvement. Decomposition showed that population growth and epidemiological changes were primary drivers of rising DALYs.

Conclusion: Declining EP incidence masks increasing absolute burden and persistent severe inequities. Our findings underscore an urgent public health imperative: to implement equity-focused interventions that enhance early diagnosis, safe management, and the preservation of fertility, particularly in low-resource settings.

Menstrual health is increasingly framed as a multidimensional public issue intersecting with health, education, and gender equality. Yet, national research landscapes remain uneven, shaped by structural neglect, epistemic silences, and sociocultural stigma. France offers a compelling case of such disparities, where academic engagement with menstrual health has only recently gained visibility. This scoping review critically maps the landscape of menstrual health research in France and identifies knowledge gaps. Following PRISMA-ScR guidelines, we analyzed twenty-eight studies retrieved from Medline and Scopus (up to November 2024), covering themes such as menstrual poverty, environmental concerns, cultural representations of menstrual blood, and menopause experiences, involving diverse populations across the life course. While the thematic diversification signals a shifting research agenda, the literature remains fragmented, with limited longitudinal and intervention studies and underrepresentation of marginalized populations. These findings underscore the need for participatory, community-driven approaches and contribute to broader debates on how menstrual health is conceptualized, studied, and translated into policy.

Objective: The aim of this study is to evaluate the safety of preconception inoculation with an inactivated SARS-CoV-2 vaccine with respect to adverse birth outcomes in newborns, to elucidate the potential association between inactivated COVID-19 vaccination and birth outcomes, and to provide scientific evidence to inform future vaccine policy development.

Methods: In this study, a prospective cohort design is adopted, including913 mother-infant pairs among 2243 pregnant and postpartum women who delivered between January 2023 and May 31, 2023, at You'ai Hospital and the Maternal and Child Health Hospital in Urumqi. On the basis of the number of preconception doses of an inactivated SARS-CoV-2 vaccine, Poisson regression models were used to analyse the safety of preconception vaccination in terms of adverse birth outcomes in newborns.

Results: Among 913 participants, 13.8% were unvaccinated (n=126), while 1-, 2-, and 3-dose BBIBP-CorV recipients accounted for 2.4% (n=22), 17.9% (n=163), and 65.9% (n=602), respectively. Stratified analysis revealed no increased risk of adverse neonatal outcomes in any vaccinated group vs unvaccinated group (1-dose: RR 1.07 [0.67-1.71]; 2-dose: 1.02 [0.80-1.31]; 3-dose: 1.03 [0.84-1.26]). Sensitivity analysis confirmed that there were no significant differences.

Conclusion: This study provides substantial evidence that prepregnancy BBIBP-CorV vaccination poses no safety concerns for neonatal outcomes. Clinically, these findings suggest that obstetricians should recommend COVID-19 vaccination during preconception counselling as a protective measure for future pregnancies. Public health implications include (1) supporting the integration of inactivated vaccines into prepregnancy health care programs to enhance immunity before gestation and (2) informing national policies to accelerate vaccine coverage among women of childbearing age, thereby reducing maternal-foetal risks in potential pandemics.

Objective: To investigate the effects of three delivery methods-vacuum extraction, forceps-assisted delivery, and cesarean section-on maternal and neonatal outcomes during prolonged deceleration (PD) in the second stage of labor, providing evidence-based support for clinical decision-making.

Methods: This retrospective cohort study analyzed 114 singleton, term pregnancies with vertex presentation experiencing PD in the second stage of labor between January 2022 and December 2024. Participants were categorized by delivery method: vacuum extraction (n=62), forceps delivery (n=30), and cesarean section (n=22). Primary outcomes included maternal morbidity indicators (eg, blood loss, hospital stay) and neonatal outcomes (eg, umbilical artery pH, NICU admission).

Results: The cesarean section group had a higher fetal station, a longer deceleration-to-delivery interval, and significantly increased maternal morbidity, including longer postpartum hospital stay, higher costs, extended antibiotic use and catheterization, and greater blood loss compared to instrumental delivery groups (all P < 0.05). The forceps group had a higher incidence of wound erythema than the cesarean group (P < 0.05). Critically, neonatal outcomes were comparable across all three groups (P > 0.05).

Conclusion: During PD in the second stage of labor, both operative vaginal delivery and cesarean section present a trade-off between maternal morbidity and procedural expediency. The choice of delivery method should be individualized, based on a rapid assessment of fetal station, labor progress, and operator expertise, as neonatal short-term outcomes were similar regardless of the mode of delivery.

Purpose: To explore the impact of rational emotive behavior therapy on the anxiety state and delivery outcomes of anxious primiparous women.

Methods: A randomized controlled trial design was employed. Sixty anxious primiparous women admitted between October 2021 and September 2022 were randomly assigned to a study group (n = 30) and a control group (n = 30). The control group received routine prenatal care, while the study group received rational emotive behavior therapy once a week for 12 weeks in addition to routine care. Anxiety levels were assessed using the Hospital Anxiety and Depression Scale, and the duration of labor and mode of delivery were recorded.

Results: After the intervention, the anxiety levels (3.97 ± 0.72 vs 6.27 ± 0.94) and depression levels (3.87 ± 0.86 vs 6.03 ± 0.93) of the mothers in the study group were significantly lower than those in the control group (P < 0.05). Regarding the duration of labor, the first stage of labor (472.83 ± 35.29 min vs 716.17 ± 32.00 min) and the second stage of labor (79.03 ± 33.94 min vs 110.10 ± 31.03 min) in the study group were significantly shorter than those in the control group (P < 0.05), while there was no significant difference in the duration of the third stage of labor between the two groups (P > 0.05). Furthermore, the spontaneous delivery rate in the study group was significantly higher than that in the control group (80.00% vs 26.67%), while the cesarean section rate and forceps delivery rate were significantly lower (P < 0.05).

Conclusion: Rational emotive behavior therapy can effectively alleviate prenatal anxiety in primiparous women, shorten labor, and improve delivery outcomes. This intervention can serve as an effective supplement to prenatal psychological care.

Purpose: Endometriosis (EMS) is a chronic gynecological disorder with unclear pathogenesis. While the vaginal and gut microbiomes are known to influence EMS, few studies have analyzed both microbiomes integrally. This study aims to characterize the vaginal and gut microbiome profiles in EMS patients and evaluate their diagnostic potential.

Patients and methods: We conducted metagenomic sequencing on 22 paired vaginal and fecal samples from EMS patients and controls. Microbial composition, diversity, and metabolic pathways were analyzed. Machine learning models were employed to assess the predictive performance of microbiome features in EMS diagnosis.

Results: EMS patients exhibited pronounced shifts in the vaginal microbiome, characterized by reduced Lactobacillus and increased Bifidobacterium and Gardnerella, which correlated with elevated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. The gut microbiome displayed decreased diversity, with a depletion of beneficial taxa such as Ruminococcus and Prevotella, alongside an enrichment of Dialister. Metabolic pathways in both microbial communities were significantly altered. Machine learning analyses demonstrated that gut microbiome features outperformed both vaginal microbiome and hormonal indices in predicting EMS, highlighting their strong diagnostic potential.

Conclusion: This study underscores the pivotal role of the gut microbiota in EMS and elucidates the complex interplay between microbial dysbiosis and disease pathogenesis. Our findings indicate that gut microbiome signatures may serve as superior diagnostic biomarkers for EMS, thereby paving the way for microbiome-based diagnostic and therapeutic strategies.

Background: Linear morphea (LM) is a chronic autoimmune disease characterized by linear or band-like localized sclerosis that may involve the dermis, subcutaneous tissue, muscle, and underlying bone. While LM typically presents in childhood, adult-onset disease is considerably less common, and LM presenting during breastfeeding has not, to our knowledge, been previously documented. As a result, therapeutic guidance for managing LM in breastfeeding women remains extremely limited, highlighting the need for additional clinical evidence in this population.

Case presentation: A 44-year-old breastfeeding woman presented with brownish-white skin lesions with a line configuration and hardened skin on the right shoulder, upper arm, forearm, hand, and fingers. The histopathological findings demonstrated epidermal thinning with flattened rete ridges, thickened fibrocollagenous connective tissue stroma extending into the subcutaneous fat, hyaline degeneration, a mild lymphocytic inflammatory, and absence of pilosebaceous unit. The laboratory analysis revealed a positive ANA test with a titer of 1:320 and the presence of anti-RNP and anti-Sm autoantibodies. The patient received hydroxychloroquine (HCQ) 200 mg twice daily and topical pimecrolimus 1% cream twice daily. After three months of observation, there was an improvement in the skin lesions. In addition, the modified localized skin index (mLoSSI) score and the localized scleroderma damage index (LoSDI) score decreased from 6 to 1 and 5 to 4, respectively. No adverse effects related to retinal toxicity were reported during the course of therapy.

Conclusion: This case suggests that the combination of oral HCQ and topical pimecrolimus may represent a safe and effective therapeutic option for LM in breastfeeding women, although further evidence is needed to confirm long-term outcomes.

Background: Endometriosis is a chronic gynecological disorder causing significant morbidity and health burden. Recent evidence suggests that lipid metabolism, particularly remnant cholesterol (RC), may be involved in its development. RC-the cholesterol content of triglyceride-rich lipoproteins (TGRLs), including chylomicrons, very low-density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL). Elevated RC is closely associated with arteriosclerosis and increased cardiovascular disease incidence, making it a valuable biomarker for assessing cardiovascular health. This study explores the association between RC levels and endometriosis prevalence in a representative sample of women.

Methods: Using cross-sectional data from NHANES (1999-2006), we analyzed 1,979 women aged 20-54 years. Weighted logistic regression models were applied to assess the relationship between RC and endometriosis. Three models were used: unadjusted (Model 1), adjusted for age, ethnicity, education, and marital status (Model 2), and fully adjusted for additional variables (Model 3). Subgroup analyses and smoothing curve fitting were also performed.

Results: Elevated RC levels were significantly associated with higher endometriosis prevalence across all models. Each 1 mg/dL above the mean level of RC was linked to a 2.3% higher incidence of endometriosis (Model 1: OR 1.023, 95% CI 1.009-1.036, p = 0.001; Model 2: OR 1.022, p = 0.004; Model 3: OR 1.023, p = 0.022). Individuals in the highest RC tertile had a higher incidence of endometriosis compared to the lowest tertile (OR 1.833, p for trend = 0.077). A linear dose-response relationship was identified, with no threshold or saturation effects.

Conclusion: The study indicates a strong correlation between elevated RC levels and increased endometriosis incidence, highlighting the potential role of lipid metabolism in endometriosis development.

Objective: This study conducted a retrospective matched analysis to explore the differences and potential associations in perinatal complications between pregnancies achieved through in-vitro fertilization-embryo transfer (IVF-ET) and natural conception.

Methods: A total of 806 pregnant women who delivered at the Department of Obstetrics, First Hospital of Lanzhou University, China, from January 2019 to August 2024 were included, with 403 cases in the experimental group and 403 matched controls (natural conception) based on admission month and gestational age (±7 days).

Results: Analysis revealed that the experimental group exhibited significantly higher incidences of multiple gestations, anemia, postpartum hemorrhage, gestational hypertension, gestational diabetes mellitus, and intrahepatic cholestasis of pregnancy compared to the control group. In singleton pregnancy analysis, these differences persisted except for pelvic inflammation. The findings suggest that ART pregnancies may increase perinatal risks through factors such as embryo manipulation, hormonal interventions, and underlying maternal pathologies.

Conclusion: This matched retrospective study highlights that IVF-ET pregnancies are associated with significantly higher risks of multiple gestations and obstetric complications, independent of multifetal pregnancies. The findings underscore the necessity of optimizing embryo transfer strategies, such as promoting single embryo transfer and implementing enhanced monitoring protocols for high-risk complications in resource-limited settings like Northwest China. This study provides regional evidence to support the development of tailored ART guidelines.