Sexual & Reproductive Healthcare最新文献_第2页

Acceptability and feasibility of a midwifery intervention to promote active labour and decision-making: a qualitative study with women and nurse-midwives 促进积极劳动和决策的助产干预的可接受性和可行性：对妇女和护士助产士的定性研究

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2025-12-01 DOI: 10.1016/j.srhc.2025.101172

Marlene Isabel Lopes , Margarida Vieira , Alexandrina Cardoso

Objectives

To evaluate the acceptability and feasibility of a complex midwifery intervention, developed in line with the MRC Framework, designed to promote active labour and support informed decision-making.

Methods

A qualitative study was conducted within community-based childbirth preparation programmes. The intervention was delivered by nurse-midwives in primary care. Semi-structured interviews with participating women and nurse-midwives were retrospectively analysed to explore perceptions of acceptability and feasibility.

Results

Women generally perceived the intervention as highly acceptable, valuing the group format, experiential and reflective elements, and the sense of preparation and confidence gained. Many described enhanced self-efficacy and agency, often reinforced by partner support. However, some reported frustration when strategies could not be applied during labour, highlighting the limits of antenatal programmes in restrictive medical contexts. Midwives also considered the programme acceptable, recognising its innovative methodology, contribution to professional development, and positive impact on women. Feasibility was reflected in women’s accounts of experiential learning, scenario-based reflection, and printed materials as mediators of practice, with reported outcomes including mobility, autonomy, and more meaningful birth experiences, though institutional constraints sometimes limited active strategies. Midwives emphasised feasibility through strong motivation, the intervention’s low cost, and its integration into routine care, while also noting challenges such as limited space, large groups, and ambivalence towards the decision-making component.

Conclusion

The intervention was acceptable to women and midwives and feasible for integration into childbirth preparation. Divergent perspectives revealed areas for refinement, underscoring the limits of antenatal programmes in medicalised contexts while highlighting the potential of context-sensitive, evidence-based interventions to strengthen women’s autonomy.

目的评估一种复杂助产干预的可接受性和可行性，该干预是根据MRC框架制定的，旨在促进主动分娩和支持知情决策。方法对社区分娩准备项目进行定性研究。干预是由初级保健的护士助产士提供的。对参与的妇女和护士助产士的半结构化访谈进行回顾性分析，以探索可接受性和可行性的看法。结果妇女普遍认为干预是高度可接受的，重视小组形式、经验和反思因素，以及获得的准备感和信心。许多人描述了自我效能感和能动性的增强，通常得到伴侣支持的强化。然而，一些人报告说，由于在分娩期间无法实施策略，因此感到沮丧，这突出了在限制性医疗环境下产前方案的局限性。助产士也认为该计划是可以接受的，承认其创新的方法，对专业发展的贡献，以及对妇女的积极影响。可行性反映在妇女对体验式学习、基于场景的反思和作为实践中介的印刷材料的描述中，报告的结果包括流动性、自主性和更有意义的分娩经验，尽管制度限制有时会限制积极的策略。助产士强调了通过强烈的动机、低成本的干预以及将其纳入常规护理的可行性，同时也指出了空间有限、群体庞大以及对决策部分的矛盾心理等挑战。结论产妇和助产士均可接受该干预措施，将其纳入分娩准备工作是可行的。不同的观点揭示了需要改进的领域，强调了在医疗化背景下产前规划的局限性，同时强调了对环境敏感、以证据为基础的干预措施在加强妇女自主权方面的潜力。

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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 : 2026-03-01 Epub 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

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 : 2026-03-01 Epub 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

Barriers and facilitators to engage with the maternity continuum of care in northwest Ethiopia: a qualitative descriptive study 障碍和促进参与产妇护理的连续性在埃塞俄比亚西北部：定性描述性研究

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.srhc.2026.101187

Birye Dessalegn Mekonnen , Vidanka Vasilevski , Ayele Geleto Bali , Linda Sweet

Aim

Globally, women’s engagement with the maternity continuum of care throughout pregnancy, childbirth, and the postpartum period helps reduce maternal and newborn deaths. However, women’s engagement with the maternity continuum of care remains low in Ethiopia, and the underlying reasons are not yet well understood. This study aimed to explore the facilitators and barriers influencing women’s engagement with the maternity continuum of care in northwest Ethiopia.

Methods

A qualitative descriptive approach was employed. Fifteen postpartum women and six healthcare workers were purposively selected and interviewed to gather diverse perspectives. Following consent, interviews were audio recorded, transcribed in Amharic, and then translated into English. Data were analysed using Braun and Clarke’s reflexive thematic analysis using NVivo 15.

Findings

Key barriers to engaging with the maternity continuum of care included limited awareness and low health literacy, difficulties in accessing and receiving care, lack of social and community support, and restrictive cultural and traditional practices. Facilitators included having awareness of maternity care and understanding of maternity care benefits, improved access to maternity services, strong support from family and social networks, and the availability of community health initiatives.

Conclusions

Multiple barriers affect women’s engagement with the maternity continuum of care. Interventions such as health education should focus on increasing awareness among women and communities about the maternity continuum of care, supporting women, and promoting positive changes within cultural norms and traditions. Strong commitment from both government and healthcare providers is essential to improve service accessibility and ensure respectful maternity care.

在全球范围内，妇女在整个怀孕、分娩和产后期间接受连续的产妇护理有助于减少孕产妇和新生儿死亡。然而，在埃塞俄比亚，妇女参与产妇连续护理的程度仍然很低，其根本原因尚未得到很好的了解。本研究旨在探讨促进因素和障碍，影响妇女参与产妇护理的连续性在埃塞俄比亚西北部。方法采用定性描述方法。有目的地选择15名产后妇女和6名保健工作者进行访谈，以收集不同的观点。在获得同意后，采访录音，用阿姆哈拉语转录，然后翻译成英语。数据分析使用Braun和Clarke的反身性专题分析，使用NVivo 15。开展产妇连续护理的主要障碍包括认识有限和卫生知识水平低、难以获得和接受护理、缺乏社会和社区支持以及限制性的文化和传统习俗。促进因素包括对产妇护理的认识和对产妇护理福利的了解、改善获得产妇服务的机会、家庭和社会网络的大力支持以及社区保健倡议的可用性。结论多重障碍影响妇女参与产妇连续护理。保健教育等干预措施应侧重于提高妇女和社区对产妇连续护理的认识，支持妇女，并促进文化规范和传统中的积极变化。政府和医疗保健提供者的坚定承诺对于改善服务可及性和确保尊重产妇护理至关重要。

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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 : 2026-03-01 Epub 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

Childbirth experiences in proactive versus standard support of labor in the latent phase– A randomized, controlled clinical trial 潜伏期主动与标准分娩支持的分娩经验-一项随机对照临床试验。

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2026-02-01 DOI: 10.1016/j.srhc.2026.101191

Marit Larsen , Anne Husby , Maria Underdal , Negin Sadati , Øyvind Salvesen , Ingebjørg Laache , Møyfrid Brenne Fehn , Raija Dahlø , Stine Bernitz , Eszter Vanky

Objective

A long latent phase followed by prolonged labor may negatively affect childbirth experience. This study investigated whether proactive support of labor (PSL), compared to standard support of labor (SSL), during the latent phase improves childbirth experience in nulliparous women. Secondary objectives were to assess the impact of labor duration on experience within PSL and SSL groups and maternal preferences for delivery mode in a hypothetical subsequent pregnancy.

Design

Randomized clinical, single-centre trial at St. Olav’s Hospital, University Hospital of Trondheim, Norway.

Population

Primiparous women from the “Proactive vs. Standard Support of Labor” study who completed the Childbirth Experience Questionnaire (CEQ).

Methods

Reported CEQ-scores six to eight weeks postpartum, were compared between the PSL and SSL groups using the Mann-Withney U test.

Main Outcome Measures

Total CEQ score and four domain scores.

Results

Of 347 participants, 305 (88%) completed the CEQ. No significant difference was found in total CEQ score between PSL (n = 172; mean 3.11, SD 0.43) and SSL (n = 133; mean 3.10, SD 0.46; p = 0.937), nor across domain scores. CEQ scores did not differ significantly between groups for labor < 12 hours (p = 0.814) or ≥ 12 hours (p = 0.404). Maternal preference for caesarean section was similar: PSL 4% vs. SSL 8%.

Conclusion

Among nulliparous women, proactive support of labor during the latent phase neither improved nor diminished childbirth experience compared with standard support, as both groups scored high on total CEQ.

目的：潜伏期过长伴产程延长可能对分娩体验产生负面影响。本研究调查了与标准分娩支持（SSL）相比，在潜伏期主动分娩支持（PSL）是否能改善无产妇女的分娩体验。次要目的是评估分娩时间对PSL组和SSL组的经验的影响以及产妇在假设的后续妊娠中对分娩方式的偏好。设计：挪威特隆赫姆大学医院St. Olav医院的随机临床单中心试验。人群：从“主动与标准分娩支持”研究中完成分娩经验问卷（CEQ）的初产妇。方法：采用Mann-Withney U检验，比较PSL组和SSL组产后6 ~ 8周的ceq评分。主要结果测量：CEQ总分和四个领域得分。结果：在347名参与者中，305名（88%）完成了CEQ。PSL （n = 172; mean 3.11, SD 0.43）与SSL （n = 133; mean 3.10, SD 0.46; p = 0.937）的CEQ总分无显著差异，各域评分间无显著差异。结论：在无产妇女中，与标准支持相比，潜伏期的主动分娩支持既没有改善也没有减少分娩体验，因为两组的总CEQ得分都很高。

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引用次数: 0

Sexual and reproductive health outcomes and parent-child communication among youth in western Kenya 肯尼亚西部青少年的性健康和生殖健康成果及亲子交流。

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI: 10.1016/j.srhc.2025.101179

Sylvia Ayieko , Nema C.M. Aluku , Abigail A. Lee , William T. Story

Purpose

The high rates of adolescent pregnancy in Kenya are due, in part, to the lack of discussions about sexual and reproductive health (SRH) between children and their parents/guardians. The aim of this study was to assess the association between parent–child communication and SRH outcomes among youth in western Kenya.

Methods

Cross-sectional data was collected in September 2022 from 1,598 youth (ages 15–24) who completed a survey about parent- child communication and SRH behaviors. Using descriptive statistics and logistic regressions, we assessed the association between parent–child communication and three SRH outcomes: intention to abstain from sex, use of family planning methods, and consistent condom use.

Results

Results showed that the intention to abstain from sex was high among all study participants (65 %). Among those with prior sexual experience, the use of family planning methods was high (68 %), while consistent condom use was low (39 %). Parent-child communication about SRH was low, with a mean score of 5.5 out of 14. Findings indicated significant positive associations between parent–child communication and intention to abstain for at least one year (AOR= 1.07; 95 % CI: 1.05–1.10), and consistent condom use (AOR = 1.08; 95 % CI: 1.03–1.12), although the use family planning methods among females was not statistically significant.

Discussion

Parents do not frequently discuss sexual topics with their children. While there were differences in rates of intention to abstain by gender, parent–child communication was significant. There is a need to equip parents and youth with SRH discussion skills to improve SRH outcomes among adolescents.

目的：肯尼亚少女怀孕率高，部分原因是儿童与其父母/监护人之间缺乏关于性健康和生殖健康的讨论。本研究的目的是评估亲子沟通与肯尼亚西部青少年性生殖健康结果之间的关系。方法：于2022年9月对1598名15-24岁青少年进行了亲子沟通和性生殖健康行为调查。使用描述性统计和逻辑回归，我们评估了亲子沟通与三个SRH结果之间的关系：放弃性行为的意图、使用计划生育方法和持续使用避孕套。结果：结果显示，所有研究参与者中禁欲的意愿都很高（65%）。在有过性经历的人群中，计划生育方法的使用率很高（68%），而一贯使用避孕套的比例很低（39%）。家长与孩子关于性生殖健康的沟通较低，平均得分为5.5分（总分14分）。研究结果显示，尽管在女性中使用计划生育方法的情况没有统计学意义，但亲子沟通与禁欲意愿至少一年（AOR= 1.07; 95% CI: 1.05-1.10）和持续使用安全套（AOR= 1.08; 95% CI: 1.03-1.12）之间存在显著正相关。讨论：父母不会经常和孩子讨论性的话题。尽管性别在戒酒意愿率上存在差异，但亲子沟通是显著的。有必要让父母和青少年掌握性健康与生殖健康的讨论技巧，以改善青少年性健康与生殖健康的结果。

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引用次数: 0

Corrigendum to “Birth interventions and outcomes among first time mothers: A population-based register study in four Nordic countries” [Sexual Reprod. Healthc. 47 (2026) 101185] “初次母亲的生育干预和结果：北欧四个国家基于人口的登记研究”的勘误表[性生殖]。中华卫生杂志，47(2026):101185]。

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2026-02-12 DOI: 10.1016/j.srhc.2026.101196

Emma Swift , Charlotte Elvander , Ellen Blix , Mika Gissler , Tiina Murto , Rikke Damkjær Maimburg , Rebecka Dalbye , Helga Gottfreðsdóttir , Kamilla Groenemeijer Nielsen , Hanna Ulfsdottir , Eva Rydahl

引用次数: 0

Unmet need for modern contraceptives and its associated factors among postpartum adolescent girls and young women in rural Mara, Tanzania: A facility-based cross-sectional study 坦桑尼亚马拉农村青春期少女和年轻妇女对现代避孕药具的需求未得到满足及其相关因素：一项基于设施的横断面研究。

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2026-02-08 DOI: 10.1016/j.srhc.2026.101195

Magnus Michael Sichalwe , Abdul Basit , Grace Tavengana , Regnald Raymond Kimaro , Manas Ranjan Behera , Attiq Ur Rehman

Background

Modern contraceptives are proven to prevent unintended pregnancies and reduce unsafe abortions; however, their utilization among adolescent girls and young women (AGYW) in sub-Saharan Africa, including Tanzania, remains low. Despite ongoing interventions, the Mara Region continues to experience a high fertility rate. This study assessed the unmet need for modern contraceptives and its associated factors among postpartum AGYW in rural Mara, Tanzania.

Methodology

A facility-based cross-sectional study was conducted among 614 AGYW aged 15–24 in rural Mara, Tanzania, selected through systematic random sampling. Data were collected in January–February 2024 using a structured Swahili questionnaire via Kobo Toolbox. SPSS v27 was used for analysis, including descriptive statistics, bivariate tests, and multivariable logistic regression, with significance set at p ≤ 0.05.

Results

Among AGYW surveyed, 21.7% were using modern contraceptives, while 37.3% had an unmet need for family planning. Unmet need was significantly higher among adolescents aged 15–18 years compared to those aged 19–24 (AOR = 1.70, 95% CI: 1.15–2.51, p = 0.008), those whose partners had no or incomplete primary education compared to those with secondary education or above (AOR = 1.66, 95% CI: 1.95–2.92, p = 0.02), and participants in the lowest wealth quintile compared to those in higher quintiles (AOR = 1.70, 95% CI: 1.11–2.60, p = 0.01).

Conclusion

Unmet need for family planning remains high among AGYW, especially younger adolescents and those from disadvantaged backgrounds. Targeted efforts are essential to improve access to contraceptive services for these groups.

背景：现代避孕药具已被证明可以预防意外怀孕和减少不安全堕胎；然而，包括坦桑尼亚在内的撒哈拉以南非洲的少女和年轻妇女（AGYW）的使用率仍然很低。尽管不断采取干预措施，马拉地区的生育率仍然很高。本研究评估了坦桑尼亚马拉农村AGYW中未满足的现代避孕药具需求及其相关因素。方法：采用系统随机抽样的方法，对坦桑尼亚马拉农村地区614名15-24岁的AGYW进行了基于设施的横断面研究。数据于2024年1月至2月通过Kobo工具箱使用结构化的斯瓦希里语问卷收集。采用SPSS v27进行分析，包括描述性统计、双变量检验、多变量logistic回归，p≤0.05为显著性。结果：接受调查的老年妇女中，21.7%的人使用现代避孕药具，37.3%的人计划生育需求未得到满足。与19-24岁的青少年相比，15-18岁的青少年未满足的需求明显更高（AOR = 1.70, 95% CI: 1.15-2.51, p = 0.008），伴侣没有或未完成初等教育的青少年与受过中等或以上教育的青少年相比（AOR = 1.66, 95% CI: 1.95-2.92, p = 0.02），最低财富五分位数的参与者与较高财富五分位数的参与者相比（AOR = 1.70, 95% CI: 1.11-2.60, p = 0.01）。结论：未满足的计划生育需求在老年妇女中仍然很高，特别是年轻的青少年和来自弱势背景的妇女。有针对性的努力对于改善这些群体获得避孕服务的机会至关重要。

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引用次数: 0

Postpartum work ability among women with severe perineal trauma at childbirth: An exploratory cross-sectional pilot study in Sweden 分娩时严重会阴创伤妇女的产后工作能力：瑞典的一项探索性横断面试点研究

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

Sexual & Reproductive Healthcare

Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.srhc.2026.101188

Katharina Tjernström , Henrik Holmberg , Kristina Edvardsson , Christine Murray , Inger Lindberg , Maria Wiklund , Margareta Persson

Objective

Existing literature offers fragmented insights into working life following severe perineal trauma (SPT), suggesting positive and negative implications. No research has systematically examined work ability or potential risk factors associated with impaired work ability. This study assessed and compared work ability among women with SPT more than 18 months postpartum and identified potential risk factors for impaired work ability.

Methods

An exploratory cross-sectional pilot study was conducted in Sweden. Participants were recruited via digital platforms (n = 197) and included women who sustained SPT during childbirth more than 18 months before data collection. Data were collected via an online questionnaire and analysed using multivariable logistic regression.

Results

Nearly one-third of participants reported impaired work ability. Absence of reconstructive surgery, increased life impact of pelvic floor disorders, and history of sick leave in adult life were identified as risk factors for impaired work ability.

Conclusions

The complexity of health problems following SPT may affect women’s ability to work. Given the exploratory nature and limited sample size of this pilot study, larger longitudinal studies – using national registers or multicentre recruitment – are needed to confirm the observed associations and deepen understanding of the multifaceted consequences of health problems following SPT.

目的：现有文献对严重会阴创伤（SPT）后的工作生活提供了零散的见解，提出了积极和消极的影响。没有研究系统地检查工作能力或与工作能力受损相关的潜在风险因素。本研究评估并比较了产后18个月以上SPT妇女的工作能力，并确定了工作能力受损的潜在危险因素。方法：在瑞典进行了一项探索性的横断面试点研究。参与者通过数字平台招募（n = 197），包括在数据收集前18个月在分娩期间持续SPT的妇女。通过在线问卷收集数据，并使用多变量逻辑回归进行分析。结果：近三分之一的参与者报告工作能力受损。缺乏重建手术，骨盆底疾病对生活的影响增加，以及成年后的病假史被确定为工作能力受损的危险因素。结论：SPT后健康问题的复杂性可能影响妇女的工作能力。鉴于该试点研究的探索性和有限的样本量，需要进行更大规模的纵向研究——使用国家登记或多中心招募——以确认观察到的关联，并加深对SPT后健康问题的多方面后果的理解。

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