Sexual & Reproductive Healthcare最新文献_第2页

Outcomes of labor induction in primiparous women with unfavorable cervical status at gestational week 41 and beyond. Does the Bishop score matter? 妊娠41周及以上宫颈状况不良的初产妇引产的结果。毕晓普的得分重要吗？

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-14 DOI: 10.1016/j.srhc.2026.101183

Ragnheidur Rósa Ólafsdóttir , Anna Eckerdal Toll , Maria Jonsson , Cecilia Ekéus

Objectives: In Sweden, induction practices have shifted, and since 2020, national guidelines recommend induction of labor (IOL) at 41 gestational weeks. This study aimed to examine mode of delivery, childbirth experience and breastfeeding initiation among primiparous undergoing IOL at gestational week ≥41+0 with a Bishop score (BS) of 0–5.

Material and methods: This cohort study was based on prospectively collected data from medical records of 348 healthy primiparous with singleton pregnancies who underwent IOL at ≥ 41 + 0 weeks of gestation with a BS of 0–5. Outcomes included mode of delivery, childbirth experience, and breastfeeding. Women were divided into two categories according to their cervical status: very unfavorable score (BS 0–3) and moderately unfavorable score (BS 4–5). Outcomes were compared using descriptive statistics and logistic regression, with odds ratios (OR) and 95% confidence intervals (CI).

Results: Emergency cesarean section (CS) was significantly more frequent among women with BS 0–3 compared to BS 4–5 (23% vs. 11%; OR 2.58, 95% CI 1.30–5.11). A negative childbirth experience (VAS < 5) was reported twice as often in the BS 0–3 group (20% vs. 10%; OR 2.08, 95% CI 1.03–4.20). No significant differences were found in the initiation of breastfeeding.

Conclusions.

Induction of labor in healthy primiparous with a BS of 0–3 at or beyond 41 weeks is associated with an increased risk of emergency cesarean section and negative childbirth experience. These findings underscore the clinical importance of various degrees of cervical ripeness before induction.

目的：在瑞典，引产实践发生了变化，自2020年以来，国家指南推荐在妊娠41周引产（IOL）。本研究旨在探讨≥41+0孕周接受IOL的初产妇的分娩方式、分娩经历和母乳喂养开始情况，Bishop评分（BS）为0 - 5。材料和方法：本队列研究基于前瞻性收集的348例健康单胎妊娠孕妇的病历资料，这些孕妇在妊娠≥41 + 0周时接受了人工晶状体植入，BS为0 - 5。结果包括分娩方式、分娩经历和母乳喂养。根据妇女的宫颈状况分为两类：非常不利评分（BS 0-3）和中等不利评分（BS 4-5）。结果采用描述性统计和逻辑回归进行比较，采用优势比（OR）和95%置信区间（CI）。结果：与BS 4-5相比，BS 0-3的妇女急诊剖宫产（CS）的发生率明显更高（23%对11%；OR 2.58, 95% CI 1.30-5.11）。BS 0-3组报告不良分娩经历（VAS < 5）的频率是对照组的两倍（20% vs. 10%; OR 2.08, 95% CI 1.03-4.20）。结论：41周及以上BS值为0-3的健康初产妇引产与急诊剖宫产和不良分娩经历的风险增加有关。这些发现强调了引产前不同程度宫颈成熟的临床重要性。

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引用次数: 0

Demographic differentials in births assisted by trained midwives in Nineteenth-Century Sweden: What difference did it make for infant survival? 19世纪瑞典由训练有素的助产士接生的人口统计学差异：对婴儿存活率有何影响？

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-28 DOI: 10.1016/j.srhc.2025.101181

Lena Karlsson

Objectives

This study examines the influence of social and demographic factors on the utilization of trained midwives in Sweden during the latter half of the nineteenth century. It also examines differences in neonatal, post-neonatal, and child mortality between births attended by trained midwives and those without such assistance.

Methods

The analysis is based on population data covering 116,597 births. Logistic regression models were used to estimate the association between midwifery, background characteristics, and mortality outcomes.

Results

The findings reveal substantial regional variation in the use of trained midwives throughout the study period. Births attended by trained midwives were more common among high-risk births and among married women compared to unmarried women. Regarding mortality, the results show an increased risk of post-neonatal mortality during the first period (1860–1869), and a decreased risk of neonatal mortality during the final period (1890–1894).

Conclusion

The study highlights the evolving role of trained midwives in childbirth practices in 19th-century Sweden and their contribution to reducing infant mortality, which coincided with the introduction of antiseptic methods from 1880 onward.

目的：本研究考察了社会和人口因素对19世纪下半叶瑞典受过培训的助产士的利用的影响。它还审查了由训练有素的助产士接生和没有这种帮助的助产士接生之间新生儿、新生儿后期和儿童死亡率的差异。方法：基于116,597例出生人口数据进行分析。使用逻辑回归模型来估计助产、背景特征和死亡率结果之间的关系。结果：研究结果显示，在整个研究期间，训练有素的助产士的使用存在实质性的区域差异。与未婚妇女相比，由受过训练的助产士接生在高危分娩和已婚妇女中更为常见。关于死亡率，研究结果表明，在第一阶段（1860-1869年）新生儿后期死亡率风险增加，而在最后阶段（1890-1894年）新生儿死亡率风险降低。结论：该研究强调了19世纪瑞典训练有素的助产士在分娩实践中不断发展的作用，以及她们对降低婴儿死亡率的贡献，这与1880年以后引入的消毒方法相吻合。

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引用次数: 0

Impact of COVID-19 on Group B Streptococcus Colonization Prevalence And Pregnancy Outcomes: A Single-Center Retrospective Study COVID-19对B族链球菌定植流行率和妊娠结局的影响：一项单中心回顾性研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-28 DOI: 10.1016/j.srhc.2025.101182

Shuang Wang , Roksana Behruzi , Muhammad Ramzan Tahir

Objectives

This study aimed to evaluate the impact of COVID-19 on the prevalence of group B Streptococcus (GBS) colonization and to examine whether the pandemic has influenced pregnancy complications among women colonized by GBS.

Methods

A retrospective chart review was conducted on 2,448 pregnant women who received care at the Outaouais Birthing Center between 2016 and 2023. Pre- and post-pandemic onset data were compared for GBS positive and negative women. Primary outcomes included termination due to miscarriage, transfers (pre- and post-32 weeks, perinatal, postnatal and newborn), reasons for transfers and newborns’ Apgar scores. The secondary outcomes included gestational age at delivery, delivery type and location, newborn birth weight, vaginal birth after cesarean (VBAC) and feeding type. Demographic data were collected to ensure group comparability.

Results

GBS prevalence was similar before (29.43 %) and after (26.59 %) COVID-19 onset (p = 0.06), with a significant spike in 2020 (32.95 %, p = 0.009). An inverse relationship was observed between COVID-19 and newborn transfers in the GBS positive group (p < 0.001). Apgar scores below 7 increased during the pandemic (p = 0.006), and reasons for perinatal transfers differed significantly (p = 0.004). In the GBS negative group, postnatal transfers were negatively correlated with COVID-19 (p < 0.001), and transfer reasons post-32 weeks (p = 0.02), perinatal (p < 0.001), and newborn (p = 0.02) transfers differed significantly.

Conclusion

COVID-19 did not increase the prevalence of GBS in pregnant women. The rise in postpartum transfers and variations in transfer reasons suggest that the pandemic may have influenced healthcare practices rather than directly increasing GBS-related complications.

目的：本研究旨在评估2019冠状病毒病（COVID-19）对B族链球菌（GBS）定植流行率的影响，并探讨该大流行是否影响了GBS定植妇女的妊娠并发症。方法：对2016 - 2023年在Outaouais分娩中心就诊的2448例孕妇进行回顾性图表分析。比较了GBS阳性和阴性妇女在大流行前后的发病数据。主要结局包括流产终止、转移（32周前和32周后、围产期、产后和新生儿）、转移原因和新生儿Apgar评分。次要结局包括分娩时胎龄、分娩类型和地点、新生儿体重、剖宫产后阴道分娩（VBAC）和喂养方式。收集人口统计数据以确保组间可比性。结果：GBS患病率在新冠肺炎发病前（29.43%）和发病后（26.59%）相似（p = 0.06），在2020年显著上升（32.95%,p = 0.009）。在GBS阳性组中，COVID-19与新生儿转移呈反比关系(p)。结论：COVID-19并未增加孕妇GBS的患病率。产后转移的增加和转移原因的变化表明，大流行可能影响了医疗保健做法，而不是直接增加了与gbs相关的并发症。

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引用次数: 0

Response to the letter to the editor regarding Women’s and healthcare providers’ experiences of contraceptive counselling: A qualitative systematic review 对致编辑的关于妇女和保健提供者避孕咨询经验的信的回应：定性系统审查

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-27 DOI: 10.1016/j.srhc.2025.101180

Márcia Conceição , Ana Sofia Ferreira , Rita Seabra , Maria Conceição Freitas , Juan Miguel Martínez-Galiano , Bruno Magalhães

引用次数: 0

Unintended pregnancies in the Global South: The role of gender equality and economic empowerment 南半球的意外怀孕：性别平等和经济赋权的作用。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-20 DOI: 10.1016/j.srhc.2025.101178

Bwalya Bupe Bwalya , Clifford Obby Odimegwu

Introduction

Millions of women in the Global South face unintended pregnancies, undermining their reproductive health, rights, and well-being, and increasing maternal health risks. These challenges perpetuate poverty and inequality. Although economic empowerment and gender equality are recognised as key predictors, their individual and combined effects on unintended pregnancies in this region remain insufficiently explored.

Methodology

The study analysed pooled, weighted normalised Demographic and Health Survey (DHS) data from 2015 to 2022 across 51 Global South countries, encompassing 432,130 currently pregnant women aged (15–49 years). Descriptive and bivariate analyses were conducted. Exploratory factor analysis was used to identify latent constructs of economic empowerment and gender equality, and binary logistic regression was used to assess their association with unintended pregnancy.

Results

Nearly a quarter of pregnancies (22.4 %) are unintended in the Global South. Latin America and the Caribbean have the highest rates (47.3 %), followed by Africa (29.0 %), and South/Southeast Asia with the lowest (10.3 %). Women’s economic empowerment and gender equality emerged as significant factors in reducing unintended pregnancies. Specifically, economic independence, reproductive health autonomy, and household autonomy were associated with lower odds of unintended pregnancies (AOR = 0.76; AOR = 0.83, and AOR = 0.95; p < 0.001), remaining strong predictors even after accounting for other socioeconomic and bio-demographic variables.

Conclusion

To reduce unintended pregnancies, policies should enhance women’s access to microcredit, promote shared household decision-making, and integrate gender empowerment into reproductive health programmes. However, the effectiveness of these interventions varies by region. For improved outcomes, policies must also address broader societal and structural factors.

全球南方数以百万计的妇女面临意外怀孕，损害了她们的生殖健康、权利和福祉，并增加了孕产妇健康风险。这些挑战使贫困和不平等永久化。尽管经济赋权和性别平等被认为是关键的预测因素，但它们对该地区意外怀孕的个别和综合影响仍未得到充分探讨。方法：该研究分析了2015年至2022年全球51个南方国家的加权标准化人口与健康调查（DHS）数据，其中包括432,130名年龄在15-49岁之间的孕妇。进行了描述性和双变量分析。探索性因素分析用于识别经济赋权和性别平等的潜在构念，并使用二元逻辑回归来评估它们与意外怀孕的关联。结果：在南半球，近四分之一（22.4%）的怀孕是意外的。拉丁美洲和加勒比地区的发病率最高（47.3%），其次是非洲（29.0%），南亚/东南亚最低（10.3%）。妇女经济赋权和性别平等成为减少意外怀孕的重要因素。具体而言，经济独立、生殖健康自主和家庭自主与较低的意外怀孕几率相关（AOR = 0.76; AOR = 0.83和AOR = 0.95）。结论：为了减少意外怀孕，政策应增加妇女获得小额信贷的机会，促进家庭共同决策，并将性别赋权纳入生殖健康方案。然而，这些干预措施的有效性因地区而异。为了改善结果，政策还必须解决更广泛的社会和结构因素。

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引用次数: 0

Reframing underserved young women’s access to reproductive services: Extending Wier et al.’s review through a life-course, gender-inclusive and digital lens 重塑服务不足的年轻女性获得生殖服务的途径：通过生命历程、性别包容和数字视角扩展Wier等人的综述。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-13 DOI: 10.1016/j.srhc.2025.101177

Endah Fitriasari, Muhammad Taufan Umasugi

引用次数: 0

A critical review of methodological approaches in contraceptive counselling research: Insights and concerns on the study by Conceição et al. (2025) 对避孕咨询研究方法的批判性回顾：对concep<s:1>等人（2025）的研究的见解和关注。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-12 DOI: 10.1016/j.srhc.2025.101176

Muhammad Taufan Umasugi

引用次数: 0

Remodeling maternal health care: evaluating the impact of implementing the midwifery model of care on maternal and neonatal health outcomes in Ethiopia: The MiMoC project 重塑孕产妇保健：评估在埃塞俄比亚实施助产护理模式对孕产妇和新生儿健康结果的影响：妇幼保健中心项目。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-10 DOI: 10.1016/j.srhc.2025.101175

Solomon Hailemeskel Beshah , Kerstin Erlandsson , Tesfanesh Lemma , Esther Lloyd , Hana Nigussie Teshome , Helena Lindgren

Background

Midwifery models of Care (MiMoC) is not standardized in in low-resourced settings, limiting the ability to evaluate the feasibility and effective in improving maternal and neonatal health outcomes compared to a standard care model.

Methods and trial

This article describes and discusses rationale, study protocol, and randomisation process for a study that will randomly allocate 1,654 pregnant women to receive or not receive MiMoC in four selected health facilities in Debre Berhan town, Ethiopia. Women will be randomly assigned to either the MiMoC group (Group A) or the standard care model (Group B) using a computer-generated randomisation scheme. In the MiMoC arm (intervention group), women will receive care during pregnancy, labour and birth, and immediate postnatal care from a single midwife or backup midwifes. Conversely, the standard care arm will involve care from various staff members at different times. To evaluate the effect of continuity of midwifery care, the principal maternal health outcome of the study will be the proportion of women having a spontaneous vaginal birth. The primary neonatal health outcome will be the proportion of neonates born preterm. In February 2025, we began recruiting women for the main study. The intervention group will be compared with the control group using an intention-to-treat analysis. Ors and 95% CIs will be estimated. The study was approved by Debre Berhan University’s Institutional Review Board and the Swedish National Ethical Review Authority.

背景：在资源匮乏的环境中，助产护理模式（MiMoC）没有标准化，与标准护理模式相比，限制了评估改善孕产妇和新生儿健康结果的可行性和有效性的能力。方法和试验：本文描述并讨论了一项研究的基本原理、研究方案和随机化过程，该研究将在埃塞俄比亚Debre Berhan镇的四个选定的卫生机构中随机分配1,654名孕妇接受或不接受MiMoC。使用计算机生成的随机方案，妇女将被随机分配到MiMoC组（A组）或标准护理模型（B组）。在MiMoC组（干预组）中，妇女将在怀孕、分娩和分娩期间接受护理，并由一名助产士或后备助产士立即提供产后护理。相反，标准护理部门将涉及不同工作人员在不同时间的护理。为了评估助产护理连续性的效果，该研究的主要产妇保健结果将是自然阴道分娩的妇女比例。新生儿健康的主要结果将是早产新生儿的比例。2025年2月，我们开始为主要研究招募女性。使用意向治疗分析将干预组与对照组进行比较。or和95% ci将被估计。这项研究得到了德布尔伯汉大学机构审查委员会和瑞典国家伦理审查机构的批准。

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引用次数: 0

Women’s and healthcare providers’ experiences of contraceptive counselling: a qualitative systematic review 妇女和卫生保健提供者的避孕咨询经验：定性系统评价。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-05 DOI: 10.1016/j.srhc.2025.101173

Márcia Conceição , Ana Sofia Ferreira , Rita Seabra , Maria Conceição Freitas , Juan Miguel Martinez-Galiano , Bruno Magalhães

Background

Persistent inequalities shape women’s access to and experiences of contraceptive care. Improving care quality requires a clearer understanding of women-provider interactions. This study aimed to synthesise women’s and healthcare providers’ experiences of contraceptive counselling.

Methods

This qualitative systematic review with inductive thematic synthesis followed the JBI methodology. Eligible studies in English, Portuguese, or Spanish published from database inception to 16 June 2025 were identified in CINAHL Ultimate, MedicLatina, MEDLINE Ultimate, the Psychology and Behavioral Sciences Collection, and Scopus. An initial limited search, development of search terms, and comprehensive database searches were undertaken; the PRISMA flow diagram summarised study selection. Two reviewers independently appraised quality using the JBI Critical Appraisal Checklist for Qualitative Research, and extracted data on study objectives, design, setting, participants, and main themes using a standardised form.

Results

Nine studies met the inclusion criteria. Six explored women’s experiences, two examined healthcare providers’ experiences, and one addressed both. Three overarching themes emerged: Contraceptive Engagement, Woman-Provider Relationship, and Decision-Making Process. Women and healthcare providers identified economic constraints, religious beliefs, and information gaps as common obstacles to contraceptive engagement.

Healthcare providers emphasised woman-centred care, aligning with women’s preference for non-judgemental, proactive, and respectful counselling. The decision-making process was the most prominent theme, with informed and respected decisions serving as central facilitators.

Conclusion

High-quality counselling requires recognising women’s needs and adopting empowerment strategies. Integrating these insights into services and expanding counselling delivered by trained healthcare providers are essential to improve access and quality. Further research should inform education and training programmes.

背景：持续的不平等影响了妇女获得避孕护理的机会和经验。提高护理质量需要更清楚地了解妇女与提供者之间的相互作用。这项研究的目的是综合妇女和保健提供者的避孕咨询经验。方法：采用JBI方法，采用归纳主题综合法进行定性系统评价。从数据库建立到2025年6月16日，在CINAHL Ultimate、MedicLatina、MEDLINE Ultimate、psychological and Behavioral Sciences Collection和Scopus中确定了符合条件的英语、葡萄牙语或西班牙语研究。进行了最初的有限搜索、搜索术语的开发和全面的数据库搜索；PRISMA流程图总结了研究选择。两位审稿人使用JBI定性研究关键评估清单独立评估质量，并使用标准化表格提取有关研究目标、设计、设置、参与者和主题的数据。结果：9项研究符合纳入标准。其中六篇研究了女性的经历，两篇研究了医疗服务提供者的经历，一篇研究了两者。出现了三个主要主题：避孕参与、妇女与提供者的关系和决策过程。妇女和卫生保健提供者认为经济限制、宗教信仰和信息差距是避孕措施实施的常见障碍。医疗保健提供者强调以妇女为中心的护理，这符合妇女对非评判性、前瞻性和尊重性咨询的偏好。决策过程是最突出的主题，知情和受尊重的决定是主要的促进因素。结论：高质量的咨询需要认识到妇女的需求并采取赋权策略。将这些见解纳入服务并扩大由训练有素的保健提供者提供的咨询，对于改善获取和质量至关重要。进一步的研究应为教育和培训方案提供信息。

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引用次数: 0

Pushed to the limit, driven by love: A qualitative study of women’s experiences of pregnancy with type 2 diabetes mellitus 被推到极限，被爱驱使：一项对怀孕2型糖尿病女性经历的定性研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-04 DOI: 10.1016/j.srhc.2025.101174

Karolina Linden , Karolina Ericson , Anneli Törnroos , Malin Bogren

Background

Pregnancy with Type 2 Diabetes Mellitus (T2DM) requires intensified medical management and self-care. However, little is known about how women experience pregnancy while living with T2DM.

Aim

To explore the pregnancy experiences of women living with T2DM.

Methods

A qualitative interview study was conducted at a specialist antenatal clinic in a university hospital in Sweden. Eleven women with a pre-pregnancy diagnosis of T2DM participated in semi-structured interviews. Data were analysed inductively using Braun and Clarke’s reflexive thematic analysis.

Findings

One overarching theme was identified: Pushed to the limit, driven by love, supported by four sub-themes. (1) A familiar diagnosis, but an unfamiliar experience described how women felt unprepared for the physical and emotional demands of pregnancy. (2) Blood glucose levels: intense monitoring and inconsistent communication highlighted how continuous monitoring was both supportive and overwhelming, with conflicting advice contributing to uncertainty. (3) When medical care outweighs emotional support captured mixed care experiences, including instances of weight stigma and lack of holistic support. (4) Pregnancy as a mental and physical trial reflected the strain of managing T2DM, while also showing the women’s determination, fueled by their care for the unborn child.

Discussion

The findings show that women with T2DM navigate a complex pregnancy experience marked by clinical intensity, emotional pressure, and inconsistent support. Despite this, their motivation to protect their babies helped them persevere.

Conclusion

Antenatal care for women with T2DM should be adapted to their specific needs, with emphasis on routine preconception counselling, coherent care pathways, and empathetic, person-centred communication.

背景妊娠合并2型糖尿病（T2DM）需要加强医疗管理和自我护理。然而，对于患有2型糖尿病的女性是如何怀孕的，我们知之甚少。目的探讨T2DM患者的妊娠经历。方法在瑞典某大学医院产前专科门诊进行定性访谈研究。11名怀孕前诊断为2型糖尿病的妇女参加了半结构化访谈。采用Braun和Clarke的反身性主题分析法对数据进行归纳分析。研究发现一个重要的主题被确定：被推到极限，由爱驱动，由四个子主题支持。(1)一个熟悉的诊断，但一个陌生的经历描述了女性对怀孕的身体和情感需求是如何措手不及的。(2)血糖水平：高强度的监测和不一致的沟通突出了持续监测是如何既支持又压倒性的，相互矛盾的建议导致了不确定性。(3)当医疗护理超过情感支持时，捕获了混合护理经验，包括体重耻辱和缺乏整体支持的实例。(4)怀孕作为一种精神和身体上的考验，反映了管理2型糖尿病的压力，同时也显示了女性的决心，受到她们对未出生孩子的照顾的推动。研究结果表明，T2DM女性经历了复杂的妊娠经历，其特点是临床强度、情绪压力和不一致的支持。尽管如此，他们保护孩子的动机帮助他们坚持下去。结论2型糖尿病妇女的产前护理应根据其具体需求进行调整，重点是常规的孕前咨询、连贯的护理途径和移情、以人为本的沟通。

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引用次数: 0