Reproductive Health最新文献

Background: The birth of a preterm baby and subsequent hospitalization in the neonatal intensive care unit (NICU) pose significant emotional challenges for fathers. Fathers often suppress their feelings to fulfill a supportive role, but active participation in caregiving may alleviate their stress and enhance bonding. This study aimed to evaluate the impact of a support program on the stress and anxiety of fathers during their first encounter with a preterm baby.

Methods: This randomized clinical trial (RCT) was conducted with a 1:1 allocation ratio at Shahid Motahari Hospital, Urmia, Iran. Eligible fathers (n = 80) of preterm babies were randomly assigned to either an experimental (n = 40) or a control (n = 40) group using a random block method with block sizes of four. Due to dropouts, 37 fathers in the experimental group and 36 in the control group were included in the analysis. The experimental group received a support program, including individualized informational and emotional support, in addition to standard NICU support. The control group received only standard NICU support. Anxiety was measured using the State-Trait Anxiety Inventory (Only the state anxiety subscale), before the first encounter and three days post-birth. Stress was assessed on day three using the Parental Stressor Scale: NICU (PSS: NICU).

Results: Post-intervention, the experimental group exhibited significantly lower mean PSS: NICU scores (M = 64.32, SD = 24.12) compared to the control group (M = 109.75, SD = 22.24; mean difference=-45.43, 95% CI [-34.58, -56.26], p < 0.001). Among the subscales of stress, the parent-child relationship and parenting roles, despite a significant decrease after the intervention in the experimental group, still had the highest stress for fathers with preterm babies. The mean State anxiety score in the experimental group (M = 43.21, SD = 9.68) was significantly lower than in the control group (M = 54.22, SD = 10.39; mean difference= -11.01, 95% CI [-6.31, -15.69], p < 0.001), indicating reduced anxiety.

Conclusion: The structured support program significantly reduced stress and anxiety among fathers of preterm babies. These findings suggest that health policymakers should consider integrating such interventions into NICU care protocols to support paternal well-being and family-centered care.

Trial registration: IRCT20200120046200N1. Dated 11/5/2020 prospectively registered. ( https://irct.behdasht.gov.ir/user/trial/46722/view ).

Introduction: Intimate partner violence (IPV) is a universal problem that exists in most countries of the world. Worldwide, one third of women will experience physical or sexual violence in their lifetime, mainly by intimate partner. IPV can affected on reproductive health and lead to serious injury and death of mother and baby. Current systematic review was conducted with the aim of determining the relationship between intimate partner violence, reproductive health and pregnancy outcome.

Material and methods: Study performed based on "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) by PICO components. The literature review was conducted using the electronic medical databases were searched using the equivalent keywords without starting time limit, up to January 2024. Medical subject headings with Boolean operators, and the proportionate keywords as follows: (fertility OR pregnancy OR child bearing) AND (intimate partner violence OR domestic violence) in title, abstract and keywords of articles were used. Inclusion criteria were published observational studies and clinical trials in English language. Studies participants considered women with a history of IPV and fertility as an outcome. Data extracted according to a predefined checklist. Two investigators independently examined title, abstract, and full-text screening. The study selection, quality assess, and extraction of data were independently by two researchers. Inconsistencies resolved by a third researcher.

Findings: A total of 1834 documents were retrieved that finally; 39 articles were reviewed. About 50% of the articles were related to the last five years. Relationship between IPV and intention to have children through "unwanted and unintended pregnancy", "contraception use", "contraception use and types of IPV and unmet need for contraception use" has a contradictory effect. Additionally, relationship between IPV and pregnancy outcomes through "maternal health", "pregnancy", "number of children and childbirth intervals" and "fetal outcomes" has a contradictory effect in different ways. According to the results, women subjected to violence may face an increased risk of pregnancy complications, abortion, stillbirth and infant death. Also, intimate partner violence may increase the incidence of induced abortion among women experiencing violence.

Conclusion: According to this review study, intimate partner violence can affect the reproductive health, and pregnancy outcome. Therefore, violence against women by the husband should be given more attention and solutions should be considered at the social and individual level for improve the reproductive health and pregnancy outcome.

Background: Overlapping and intersecting structural violence facing im/migrant sex workers has contributed to significant sexual health inequities, such as reduced odds of recent HIV testing, Sexually transmitted and blood borne illness treatment, and client condom refusal. Limited research has been conducted among im/migrant sex workers around access to contraception, particularly using an intersectional lens. The purpose of this paper is to examine the association between im/migration status and difficulty accessing non-barrier contraception among a prospective, community-based cohort of sex workers in Metro Vancouver, Canada, as well as whether this association is modified by racialization.

Methods: Semi-annual questionnaire data were drawn from AESHA (An Evaluation of Sex Workers Health Access), an open, community-based longitudinal cohort of women sex workers in Vancouver, Canada (January 2010 - August 2022). We assessed the association between im/migration status and difficulty accessing non-barrier contraceptives (last 6 months), using racialization (Asian, Black, Latinx, or other racialized identity) as an effect modifier. We developed a multivariable confounder model using modified Poisson regression with generalized estimating equations using sandwich robust standard error.

Results: Eight hundred and three participants were included, contributing a total of 5,133 observations over 12.8 years. The median number of visits per participant was four (range: 1-24). 32.6% of participants were im/migrants to Canada and 34.5% were Asian, Black, Latinx, or another racialized identity. In adjusted multivariable analysis exploring racialized identity as an effect modifier, participants who were both im/migrants and racialized faced the highest risk of experiencing difficulties accessing non-barrier contraceptives, when compared to non-im/migrant and non-racialized sex workers (Risk Ratio: 1.50; 95% CI: 0.99, 2.28).

Conclusions: One-quarter of all participants reported experiencing difficulty accessing non-barrier contraceptives at least once during the study period. Im/migrant women sex workers who are Asian, Black, Latinx, or another racialized identity faced a greater risk of experiencing difficulties accessing non-barrier contraceptives compared to non-racialized, non-im/migrant sex workers. These findings indicate a critical need towards investment in culturally safe, linguistically congruent, and sex work-friendly sexual health services to increase contraceptive access and reduce the potential for sexual health inequities.