Women & Health最新文献

Hypertensive disorders of pregnancy (HDP) and chronic hypertension (CHTN) are related to maternal and infant morbidity and mortality. We aimed to assess HDP and CHTN prevalence changes before (January 2015-February 2020) and during the COVID-19 pandemic (March 2020-December 2021) in South Carolina (SC). SC live births (2015-2021) were included (194,841 non-Hispanic White [NHW]); 108,195 non-Hispanic Black [NHB]; 25,560 Hispanic; 16,346 other race/ethnicity). Linked birth certificate and hospitalization/ED data was used. Relative risks (RRs) and 95 percent CIs adjusted for potential confounders estimated HDP and CHTN risk before and during the pandemic. HDP risk is associated with a one-year increase in calendar time pre-pandemic differed by race/ethnicity. Corresponding RRs (95 percent CIs) were 1.06 (1.05-1.06) in NHW, 1.07 (1.06-1.07) in NHB, 1.07 (1.06-1.09) in Hispanic and 1.09 (1.07-1.12) for other races/ethnicities. During the pandemic, RRs (95 percent CIs) attenuated slightly remaining significant (NHW, 1.03 [1.01-1.04]; NHB, 1.04 [1.02-1.05]; Hispanic, 1.04 [1.02-1.07]; other races/ethnicities, 1.06 [1.04-1.09]). Increasing race-ethnic group-specific trends from 2015 to 2021 were reported for CHTN (NHW, 1.09 [1.08-1.10]; NHB, 1.09 [1.08-1.10]; Hispanic, 1.08 [1.05-1.12]; other races/ethnicities, 1.15 [1.11-1.19]). HDP and CHTN's increasing prevalence from 2015 to 2021 differed by race/ethnicity, with HDP impacted by the pandemic and upward trends observed for both conditions after adjustment. Screening, diagnostic, and reporting practices across different data sources and actual changes may impact HDP and CHTN prevalence.

In this study, we investigated the factors that influence families' decision-making processes about whether to carry a pregnancy to term or to terminate it in cases of fetal anomalies. A questionnaire was administered to 25 participants who chose to terminate their pregnancy and 25 participants who chose to carry their pregnancy to term. Among the sociodemographic characteristics investigated, only monthly income significantly differed between the groups (p = .044), being higher in the termination group. The participants in the non-termination group decided to proceed in a shorter time (p = .014). The majority of the participants in this group made this decision for religious reasons (56 percent), while in the other group, the decision was mostly based on baby-centered or parent-centered factors (48 percent and 52 percent, respectively) (p < .001). In the non-termination group, there was a significantly higher number of participants who expressed that their religious beliefs played an influential role in their decision (p = .002). In contrast, in the termination group, higher number of participants indicated that the information provided by their doctor was very effective in shaping their decisions (p < .001). According to the results of our study, social, cultural, and religious reasons seem to be the most important factors affecting participants' decisions related to pregnancy termination.

Background: A growing body of evidence suggests a potential link between the SARS-CoV-2 vaccine and menstrual changes in women who were menstruating at the time of vaccination. Nevertheless, the prevalence of this event in those with secondary amenorrhea for different causes, i.e. formerly menstruating women, remains unclear. It is plausible that, analogous to those observed in currently menstruating women, they experienced some degree of alteration in their reproductive health, defined here as menstrual-related disturbances.

Objective: The aim was to analyze this phenomenon and identify the factors associated with the occurrence of menstrual-related disturbances in this subpopulation. Study design: A retrospective observational cross-sectional study was conducted among adult Spanish in December 2021 using an online survey (N = 17,512). The present analysis includes a subpopulation of vaccinated and formerly menstruating women (N = 548). General characteristics, medical history, and adverse events following COVID-19 vaccination were recorded. Chi-square, Mann-Whitney U and McNemar mid-P tests were performed. Bivariate logistic regression was then used to identify the key factors influencing this unexpected event.

Results: In comparison with the first dose, significantly higher percentages of respondents experienced menstrual-related disturbances (dose 1: 38.5 percent vs. dose 2: 44.8 percent) after receiving the second one. Among them, those related to the length and flow stand out, being of long-term nature in about 17-20 percent of cases. Interindividual factors influencing this unexpected event after receiving the dose 1 may include weight, perimenopause, preexisting diagnoses of non-autoimmune rheumatic/articular conditions, use of hormonal contraceptives, suffering from other vaccine side effects - such as arm pain and the number of previous pregnancies; for dose 2, these factors may include suffering from menstrual-related alterations after receiving dose 1, as well as the use of hormonal contraceptives and perimenopause.

Conclusion: Formerly menstruating women might experience long-term menstrual-related disturbances following COVID-19 vaccination. Potential influencing factors include weight, perimenopause, rheumatic/articular conditions, hormonal contraceptives, vaccine side effects and previous pregnancies.

In Qatar, hormonal contraceptives are available over the counter in community pharmacies. However, improper use, particularly by women with specific health conditions, can result in adverse events. Community pharmacists (CPs) play a role in counseling women and assessing eligibility for contraceptives. This study evaluated the knowledge, attitudes, and practices of CPs in Qatar regarding hormonal contraceptives through a survey conducted from August to December 2021. Of 377 respondents, 136 completed the questionnaire (response rate: 35.3 percent). The mean knowledge score was 3.01, reflecting poor to moderate knowledge. The score fell between 3 and 4, with a maximum score of 6. CPs mostly counseled patients about contraceptives' names, instructions on administration, and when to start (82.2 percent, 90.2 percent, and 90 percent respectively). About 40 percent of CPs agreed that their religious beliefs do not affect recommendations about contraceptives. Lack of private rooms (57 percent), and limited counseling time (55.1 percent) were identified as counseling barriers. The study concluded that CPs had poor to moderate knowledge but positive attitudes and fair to good counseling practices, suggesting a need for educational programs and interventions to overcome barriers.

This randomized controlled intervention study aims to determine the effect of an abdominal binder on pain, bleeding, and breastfeeding success after cesarean delivery. The study was conducted with women who underwent cesarean section and were followed-up for the first 48 hours at the obstetrics clinic of a state hospital in Türkiye between September 2020-March 2021. The study was completed with a total of 128 women who met the inclusion criteria (Intervention (IG):64, Control (CG):64). Data were collected using a "Socio-demographic Form" and "Postpartum Follow-up Form." Statistical significance was defined as p < .05. The IG showed significantly lower pain scores in both the abdominal area (uterine involution) and cesarean incision compared to the CG (p < .001), (respectively, IG:0.19 ± 0.58 vs. CG:1.33 ± 1.16; IG:0.23 ± 0.61 vs. CG:0.75 ± 1.26). The amount of puerperal bleeding was significantly lower in the IG (p < .001) (IG:327.65 ± 112.61 mL vs. CG:402.61 ± 157.45 mL), and their hemoglobin and hematocrit values were significantly higher (p < .05) (Hemoglobin, IG:11.00 ± 0.78 g/dL vs. CG:10.62 ± 0.90 g/dL; Hematocrit, IG:34.54 ± 1.79 percent vs. CG:33.51 ± 2.56 percent). The breastfeeding success scores were significantly higher in the IG (p < .001) (IG:9.97 ± 0.17 vs. CG:9.81 ± 0.43). These data demonstrate that the abdominal binder is beneficial and applicable for reducing pain, bleeding, and for improving breastfeeding success in the first 48 hours after cesarean delivery.

This is a descriptive study based on National Family Health Survey- Round 5 (2020-21) dataset, comparing two groups of Indian women: "stay-behind pregnant women" and "women who are living with their husbands." We applied z-test analyzing health status and healthcare access between the two groups. The result shows both health status (D_{Mean Hemoglobin} = -2.02, p = .002; _{DMean Sys BP} = -2.48, p = .001; D_{Mean Dias BP} = -1.53, p = .003; D_Anemic = 0.04, p = .006) and healthcare access (D_{Access to public healthcare} = -4.6 percent, p = .005; D_{Access to private healthcare} = 10.4 percent, p = .002, D_Others = -9.3 percent, p = .001) are significantly lower among "stay-behind pregnant women." The intake of nutritious food among stay-behind pregnant women is relatively low (D_Pulses = -7.9 percent, p = .003; D_Veg = -3.4 percent, p = .002; D_Fruits = -5.5 percent, 0.005; D_Eggs = -3.8 percent, p = .004; D_Meat = -3.4 percent, p = .002) which contributes to their poor health status. Overall, it is concluded that the health status and healthcare access of "stay-behind pregnant women" are poorer than others. Future studies can explore the role of empowerment of "stay-behind pregnant women" in ensuring their better health and healthcare access.

Although studies have shown an increase in the representation of women in academic anesthesiology, it remains one of the medical specialties most dominated by men. While gender disparities have been identified in academic anesthesiology, literature on discrepancies in funding allocated by the National Institutes of Health (NIH) is scarce. The objective of the present study was to explore these discrepancies from 2017 to 2020 and assess potential changes in funding trends over time. Publicly available funding data was retrospectively obtained from the NIH Research Portfolio Online Reporting Tools Expenditure and Results (RePORTER) database for fiscal years 2017 to 2020. Information regarding each principal investigator (PI) was obtained from the Scopus database and institutional websites. For statistical comparison of continuous variables, Mann-Whitney U tests were performed. Simple linear regression analyses assessed the relationship between fiscal year and number of NIH grants awarded to PIs. Median NIH amount per grant [interquartile range (IQR)] was determined to be $359,038 ($233,947-$476,933) for PIs that were men, greater than that of $330,865 ($164,268-$458,785) for PIs that were women (p < .05). Similarly, men received a greater median NIH grant amount per PI, with a value of $348,751 ($222,043-$442,075), compared to women who received $268,634 ($161,159-$414,384) (p < .05). When stratified by terminal degree, significantly higher median grant amounts (p < .05) were awarded to MD and PhD holders who were men versus their women counterparts. Lastly, an increasing trend in obtaining NIH grants between 2017 and 2020 was observed for PIs that were men overall, including PIs holding MD/PhD degrees (p < .05). No such trend was observed for PIs who were women. This study demonstrates a significantly greater number of NIH grants and higher award values allocated to researchers who were men than researchers who were women in academic anesthesiology over the past four years. Moreover, an increase in the number of grants secured by PIs who were women from 2017-2020 was not observed. In the future, longitudinal trends in NIH funding for principal investigators (PIs) of both genders in anesthesiology should be investigated.

A novel breastfeeding mobile app was created. We aim to determine if patients who utilize the app will have longer breastfeeding duration, improved breastfeeding self-efficacy scores at 1-year follow-up, and higher exclusive breastfeeding rates at 6 months postpartum. Participants were randomized, with 45 to the intervention and 48 to the control groups. Surveys were administered at 32-36-week gestation and 1 year postpartum. On average, women in the intervention group breastfed for 10.1 (SD ± 3.5) months compared to 8.9 (SD ± 4.1) months in the control group (p = .320). A Kaplan-Meier survival curve demonstrated a higher proportion of participants who breastfed for longer durations in the intervention group (p = .241). The change in self-efficacy was not statistically different in the two groups. The exclusive breastfeeding rate at 6 months postpartum is 81.3 percent in the intervention group and 60.0 percent in the control group (p = .277). While there is no statistical difference in breastfeeding outcomes, participant feedback suggests that features such as feeding-trackers, real-time lactation support, and moderated peer groups may enhance its impact. Future research should focus on refining these elements, recruiting larger samples, and minimizing loss-to-follow-up to fully assess the potential of mobile-based breastfeeding interventions.

The termination of pregnancy is considered an emotionally devastating experience. Early intervention and counseling are essential to prevent adverse complications following pregnancy loss. This study aimed to determine the effect of nursing care based on Swanson's Theory of Caring on women's prenatal grief, depression, anxiety, stress, and coping levels during pregnancy termination. The training and counseling program, based on Swanson's Theory of Caring, included hospital care, a mobile application, and telephone follow-ups. We conducted this prospective randomized controlled experimental study in the gynecology and obstetrics clinic of a tertiary university hospital in Türkiye between September 2021 and May 2022. The study sample consisted of 50 women (intervention group: 25, control group: 25) whose pregnancy was terminated in the second trimester. The women were assigned to groups according to a randomization list created by a statistician. Data collection tools included a Personal Information Form, the Perinatal Grief Scale, the Depression, Anxiety, and Stress Scale, the Coping and Adaptation Process Scale, and the Numerical Rating Scale. We collected the data during hospitalization, between the 6^th and 8^thweeks after discharge, and at the 12^thweek. We performed a chi-square test, a paired samples t-test, and an independent samples t-test on the IBM Statistical Package for the Social Sciences Statistics 26. The intervention group had lower mean perinatal grief (54.76 ± 19.49), depression (2.56 ± 2.39), anxiety (2.08 ± 2.10), and stress (3.52 ± 1.78) scores and higher mean coping and adjustment scores (140.48 ± 11.47) than the control group(p < .05). The intervention group also had a lower perception of labor pain, shorter discharge time, and a higher level of readiness for a new pregnancy (p < .05). The program that we applied in the study was effective in managing the pregnancy termination and post-discharge period in the population we studied.