Sexual & Reproductive Healthcare最新文献

英文中文

Association between quality of antenatal care service utilisation and adverse birth outcomes among adolescent women in 22 Sub-Saharan African countries. A mixed-effects multilevel analysis 22 个撒哈拉以南非洲国家少女产前保健服务利用质量与不良分娩结果之间的关系。混合效应多层次分析

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-10-09 DOI: 10.1016/j.srhc.2024.101036

Tadesse Tolossa , Lisa Gold , Eric HY Lau , Merga Dheresa , Julie Abimanyi-Ochom

Objectives

This study aimed to assess the association between the quality of antenatal care (ANC) service utilisation and adverse birth outcomes among adolescent women in Sub-Saharan Africa (SSA).

Methods

A two-level mixed-effects model was employed using the recent Demographic Health Survey (DHS) data from 22 SSA countries. Both bivariable and multivariable multilevel analyses were conducted to assess the association between individual and community level factors with adverse birth outcomes. The results of the fixed effects model were interpreted in the form of adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs).

Results

In SSA, 23.5 % of adolescent mothers experienced adverse birth outcomes. This study found that receiving high quality ANC was associated with a 28 % reduction in the likelihood of adverse birth outcomes (AOR = 0.72, 95 % CI: 0.63, 0.83). Among the individual-level factors, middle-aged adolescence (AOR = 1.23, 95 % CI: 1.11, 1.36), being a female newborn (AOR = 1.15, 95 % CI: 1.05, 1.26), single marital status (AOR = 0.87, 95 % CI: 0.78, 0.96) and higher educational status (AOR = 0.83, 95 % CI: 0.74, 0.93) were significantly associated with adverse birth outcomes. From the community-level variables, women from Eastern Africa had positive significant association with adverse birth outcomes (AOR = 1.30, 95 % CI: 1.15, 1.46).

Conclusions

Nearly one-fourth of adolescent women in SSA experienced at least one type of adverse birth outcome. Low quality of ANC was significantly associated with adverse birth outcomes. Policymakers need to consider a comprehensive, essential, and minimal package of ANC to enhance the quality of ANC, which is crucial for better adolescent birth outcomes.

本研究旨在评估产前保健（ANC）服务利用质量与撒哈拉以南非洲地区（SSA）青少年女性不良分娩结局之间的关系。方法利用最近来自 22 个撒哈拉以南非洲地区国家的人口健康调查（DHS）数据，采用两级混合效应模型。采用双变量和多变量多层次分析来评估个人和社区因素与不良生育后果之间的关系。固定效应模型的结果以调整后的几率比（AORs）和 95% 的置信区间（95% CIs）来解释。本研究发现，接受高质量产前护理与不良分娩结局发生率降低 28% 相关（AOR = 0.72，95% CI：0.63, 0.83）。在个人层面的因素中，中年青春期（AOR = 1.23，95 % CI：1.11，1.36）、女性新生儿（AOR = 1.15，95 % CI：1.05，1.26）、单身婚姻状况（AOR = 0.87，95 % CI：0.78，0.96）和较高的教育程度（AOR = 0.83，95 % CI：0.74，0.93）与不良分娩结局显著相关。从社区层面的变量来看，来自东非的妇女与不良分娩结局呈显著正相关（AOR = 1.30，95 % CI：1.15，1.46）。低质量的产前护理与不良分娩结局有很大关系。政策制定者需要考虑全面、基本和最低限度的产前护理一揽子计划，以提高产前护理的质量，这对改善青少年的分娩结果至关重要。

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引用次数: 0

Condom non-use among adolescents: Prevalence and associated factors among school-going adolescents from 58 countries 青少年不使用安全套的情况：来自 58 个国家的在校青少年中不使用安全套的情况及其相关因素。

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-30 DOI: 10.1016/j.srhc.2024.101035

Nazifa Nawal Huda , Rashawan Raziur Rouf , Md Shajedur Rahman Shawon

Objectives

Studies in several resource-limited settings have investigated the prevalence and potential factors associated with condom non-use among adolescents, showing inconsistent and varied findings, owing to methodological inconsistencies. Thus, this study aimed to investigate the prevalence and associated factors of condom non-use among a global sample of adolescents and their differences based on sex and region.

Methods

We conducted a cross-sectional study using the 2009–2018 Global School-based Health Survey data from 58 countries which included 183,100 adolescents aged 12–15 years. Random-effects meta-analysis was used to estimate the overall and regional pooled prevalence of condom non-use. Multilevel mixed-effect logistic regressions were used to investigate the correlates of condom non-use.

Results

Overall, 26.2% of the total sample reported being sexually active and of these, 27.6% did not use condoms during last intercourse, with boys reporting higher than girls (27.9% vs. 25.6%). The prevalence of condom non-use was the highest in the African region (29.2%) and the lowest in the South-East Asia region (21.1%). There were variations in prevalence across countries, regions, and sex. Female gender, older age, loneliness, suicidal ideation, being bullied, parental support and supervision, truancy, smoking, illicit drug use, early sexual initiation, and having multiple sex partners were associated with condom non-use. There was evidence of heterogeneity of correlates across regions and sex.

Conclusions

In this analysis, we found variations in the prevalence and associated factors of condom non-use among adolescents by sex and region. These findings can shape effective sexual health initiatives and improve resource distribution across regions.

研究目的在一些资源有限的环境中进行的研究调查了青少年不使用安全套的普遍程度和潜在相关因素，由于方法不一致，研究结果也不一致且各不相同。因此，本研究旨在调查全球青少年样本中不使用安全套的流行率和相关因素，以及不同性别和地区的差异：我们利用来自 58 个国家的 2009-2018 年全球学校健康调查数据开展了一项横断面研究，其中包括 183100 名 12-15 岁的青少年。研究采用随机效应荟萃分析法估算不使用安全套的总体流行率和地区流行率。多层次混合效应逻辑回归用于研究不使用安全套的相关因素：总体而言，26.2%的样本报告性生活活跃，其中 27.6%的样本在最后一次性交时没有使用安全套，男生报告的比例高于女生（27.9% 对 25.6%）。非洲地区不使用安全套的比例最高（29.2%），东南亚地区最低（21.1%）。不同国家、不同地区和不同性别的感染率存在差异。女性性别、年龄较大、孤独、自杀倾向、被欺凌、父母的支持和监督、逃学、吸烟、使用非法药物、过早开始性行为以及有多个性伴侣与不使用安全套有关。有证据表明，不同地区和不同性别的相关因素存在异质性：在这项分析中，我们发现不同性别和地区的青少年不使用安全套的发生率和相关因素存在差异。这些发现可以帮助我们制定有效的性健康计划，并改善各地区的资源分配。

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引用次数: 0

Examining the impact of an online educational video on the contraceptive knowledge, awareness and choices of young women living in rural and remote Australia 研究在线教育视频对澳大利亚农村和偏远地区年轻女性避孕知识、意识和选择的影响。

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-26 DOI: 10.1016/j.srhc.2024.101034

Danielle Mazza, Jessica R Botfield, Jessie Zeng, Claudia Morando-Stokoe, Noushin Arefadib

Objective

To assess whether an online educational video, tailored to young women living in rural and remote areas, increases their contraceptive knowledge, preference for and uptake of long-acting reversible contraception (LARC).

Study Design

A single group pre-post survey design, in which participants completed the pre-video survey (S1), watched the 13-min video, then completed a survey immediately after (S2) and 6 months later (S3). Outcomes were analysed using McNemar tests and multivariate logistic regression.

Results

A total of 153 participants watched the video and completed S1 and S2; 56 % of these completed S3. Prevideo (S1) 33 % of participants were unaware of LARC methods. Only 3 % rated their knowledge about every method as high. Knowledge improved immediately post video (S2) for all methods (aOR 12.5, 95 % CI 5.2 to 29.8) and LARC methods (aOR 7.9, 95 % CI 4.3 to 11.8). Overall method preference for LARC increased from 23.5 % (n = 36) at S1 to 48 % (n = 74) at S2. Likelihood of using a LARC increased at S2 (aOR 2.1, 95 % CI 1.5 to 2.9). The overall proportion of participants using a LARC increased from 18 % at S1 to 21 % at S3, however, this increase was not significant (p = 0.3).

Conclusion

Our findings underscore the effectiveness of tailored online educational videos in enhancing contraceptive knowledge and preference for LARCs amongst young women living in rural and remote areas. However preference did not translate into uptake, suggesting that structural and other barriers may be prominent.

Implications

This study emphasises the need for a multifaceted approach to facilitating young womens’ access to effective methods of contraception, including LARC. Efforts to promote knowledge should be coordinated with place-based initiatives and policies that directly address the structural barriers to accessing critical sexual and reproductive health services unique to women in rural and remote areas.

研究目的：评估针对农村和偏远地区年轻女性的在线教育视频是否能提高她们的避孕知识、对长效可逆避孕药具（LARC）的偏好和使用率：评估针对生活在农村和偏远地区的年轻女性量身定制的在线教育视频是否能提高她们的避孕知识、对长效可逆避孕药具（LARC）的偏好和使用率：研究设计：采用单组前-后调查设计，参与者完成视频前调查（S1），观看 13 分钟视频，然后立即完成调查（S2）和 6 个月后（S3）。结果采用 McNemar 检验和多变量逻辑回归进行分析：共有 153 名参与者观看了视频并完成了 S1 和 S2；其中 56% 完成了 S3。观看视频（S1）前，33% 的参与者不了解 LARC 方法。只有 3% 的人认为他们对每种方法的了解程度都很高。观看视频（S2）后，对所有方法（aOR 12.5，95 % CI 5.2 至 29.8）和 LARC 方法（aOR 7.9，95 % CI 4.3 至 11.8）的了解程度立即提高。对 LARC 方法的总体偏好从 S1 阶段的 23.5%（n = 36）增加到 S2 阶段的 48%（n = 74）。使用 LARC 的可能性在第二次调查时有所增加（aOR 2.1，95 % CI 1.5 至 2.9）。使用 LARC 的总体比例从 S1 的 18% 增加到 S3 的 21%，但这一增加并不显著（p = 0.3）：我们的研究结果表明，量身定制的在线教育视频能有效提高农村和偏远地区年轻女性的避孕知识和对 LARCs 的偏好。然而，偏好并没有转化为接受，这表明结构性障碍和其他障碍可能很突出：这项研究强调，有必要采取多方面的方法，帮助年轻女性获得有效的避孕方法，包括 LARC。促进知识普及的工作应与基于地方的倡议和政策相协调，直接解决农村和偏远地区妇女在获得关键性健康和生殖健康服务方面所面临的结构性障碍。

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引用次数: 0

Investigating the associations between early labour onset symptoms and self-diagnosed labour onset in a cohort study of primiparas 在一项初产妇队列研究中调查早产症状与自我诊断早产之间的关系

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-10 DOI: 10.1016/j.srhc.2024.101033

Hanna Gehling, Loukia M. Spineli , Mechthild M. Gross

Objective

The early recognition of possible labour onset symptoms may be pivotal to identifying the beginning of early labour and are usually recognised by the birthing women themselves. The present study illustrates the interrelationship among five labour-onset symptoms and explores the association of these labour-onset symptoms with the self-diagnosed labour onset of primiparas.

Methods

A prospective cohort study on a sample of 69 primigravida in Giessen, Germany, expecting spontaneous onset of labour at term. The participants filled in a diary from ≥37 + 0 weeks gestation until self-diagnosed labour onset. Descriptive, bivariate and inferential analysis explored association of labour onset symptoms with self-diagnosed labour onset while accounting for maternal and newborn characteristics.

Results

Self-diagnosed labour onset was positively associated with all symptoms and clinical characteristics, apart from irregular pain and maternal weight and age. Moreover, regular pain was negatively correlated with irregular pain; having regular pain increased the odds of self-diagnosed labour onset substantially (OR: 10.18, 95 % CI: 2.39–66.27), followed by gastrointestinal symptoms (OR: 2.07, 95 % CI: 0.40–13.10) and emotional symptoms (OR: 2.05, 95% CI: 0.30–13.98).

Conclusion

Being the initiator of intrapartum care without any birth experience, primiparas are prone to experiencing dissatisfaction in care and may enter professional care too late or too early. The present study showed that regular pain may signify primiparas to self-diagnose labour onset within 24 h and indicate early labour symptoms that may be relevant for a self-diagnosed labour onset.

目的早期识别可能出现的临产症状可能是确定早产开始的关键，这些症状通常由分娩妇女自己识别。本研究阐述了五种临产症状之间的相互关系，并探讨了这些临产症状与初产妇自我诊断的临产症状之间的关联。参与者填写了从妊娠≥37 + 0 周到自我诊断分娩开始的日记。描述性分析、双变量分析和推理分析探讨了临产症状与自我诊断临产的相关性，同时考虑了产妇和新生儿的特征。此外，有规律的疼痛与无规律的疼痛呈负相关；有规律的疼痛会大大增加自我诊断为临产的几率（OR：10.18，95 % CI：2.39-66.27），其次是胃肠道症状（OR：2.07，95 % CI：0.40-13.10）和情绪症状（OR：2.07，95 % CI：0.40-13.10）。结论初产妇作为没有任何分娩经验的产前护理的发起者，很容易对护理感到不满，并可能过晚或过早进入专业护理。本研究表明，有规律的疼痛可能是初产妇在 24 小时内自我诊断分娩开始的信号，并提示可能与自我诊断分娩开始相关的早期分娩症状。

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引用次数: 0

Overuse of intrapartum CTG monitoring in low-risk women in Norway 挪威低风险产妇过度使用产前 CTG 监测

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-05 DOI: 10.1016/j.srhc.2024.101032

Kristin Jerve Aanstad , Are Hugo Pripp , Rebecka Dalbye , Aase Devold Pay , Anne Cathrine Staff , Anne Kaasen , Ellen Blix

引用次数: 0

The conclusion of CTG overuse is not justified 过度使用 CTG 的结论是没有道理的。

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-09-01 DOI: 10.1016/j.srhc.2024.101031

Jørg Kessler , Sindre Grindheim , Johanne Kolvik Iversen

引用次数: 0

Hysterectomy and medical financial hardship among U.S. women 子宫切除术与美国妇女的医疗经济困难

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-28 DOI: 10.1016/j.srhc.2024.101019

Biplab Kumar Datta , Ashwini Tiwari , Yara H. Abdelgawad , Ruhun Wasata

Objective

Hysterectomy is one of the common surgical procedures for women in the United States. Studies show that hysterectomy is associated with elevated risk of developing chronic conditions, which may cause financial toxicity in patients. This study aimed to assess whether women who underwent hysterectomy had a higher risk of experiencing medical financial hardship compared to women who didn’t.

Methods

Using data on 32,823 adult women from the 2019 and 2021 waves of the National Health Interview Survey, we estimated binomial and multinomial logistic regressions to assess the relationship between hysterectomy and financial hardship, defined as problems paying or unable to pay any medical bills. Further, we performed a Karlson-Holm-Breen (KHB) decomposition to examine whether the association could be explained by chronic comorbidity.

Results

While the prevalence of financial hardship was 13.6 % among all women, it was 16.2 % among women who underwent a hysterectomy. The adjusted odds of experiencing medical financial hardship among women with a hysterectomy were 1.36 (95 % CI: 1.22–1.52) times that of their counterparts who did not have a hysterectomy. The KHB decomposition suggested that 34.5 % of the size of the effect was attributable to chronic conditions. Women who had a hysterectomy were also 1.45 (95 % CI: 1.26–1.67) times more likely to have unpaid medical debts.

Conclusions

Our results suggested that women, who underwent a hysterectomy in the US, were vulnerable to medical financial hardship. Policy makers and health professionals should be made aware of this issue to help women coping against this adversity.

目的子宫切除术是美国妇女常见的外科手术之一。研究表明，子宫切除术与罹患慢性疾病的风险升高有关，这可能会给患者带来经济上的负担。本研究旨在评估与未接受子宫切除术的女性相比，接受子宫切除术的女性是否会有更高的医疗经济困难风险。方法利用2019年和2021年两波全国健康访谈调查（National Health Interview Survey）中32,823名成年女性的数据，我们估计了二项式和多项式逻辑回归，以评估子宫切除术与经济困难之间的关系，经济困难的定义是有问题支付或无法支付任何医疗账单。此外，我们还进行了卡尔森-霍尔姆-布林（Karlson-Holm-Breen，KHB）分解，以检验慢性合并症是否可以解释这种关联。结果虽然在所有女性中，经济困难的发生率为 13.6%，但在接受子宫切除术的女性中，这一比例为 16.2%。接受过子宫切除术的妇女经历医疗经济困难的调整后几率是未接受子宫切除术的妇女的 1.36 倍（95 % CI：1.22-1.52）。KHB 分解表明，34.5% 的影响可归因于慢性病。我们的研究结果表明，在美国接受子宫切除术的妇女很容易陷入医疗经济困境。决策者和医疗专业人员应该意识到这一问题，以帮助妇女应对这一困境。

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引用次数: 0

The vital role of birth centers in modern maternity care 分娩中心在现代产妇护理中的重要作用

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-26 DOI: 10.1016/j.srhc.2024.101020

Emma M Swift, Berglind Halfdansdottir

引用次数: 0

Comment on the study by Aanstad et al. “Intrapartum fetal monitoring practices in Norway: A population-based study” 就 Aanstad 等人的研究 "挪威的产前胎儿监护实践：基于人口的研究"

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-23 DOI: 10.1016/j.srhc.2024.101018

Katariina Laine , Sari Räisänen , Branka M. Yli , Tiril Tingleff

引用次数: 0

A low cesarean section rate is not a reason for overusing CTG 剖宫产率低不是过度使用 CTG 的理由

IF 1.4 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2024-08-23 DOI: 10.1016/j.srhc.2024.101017

Kristin Jerve Aanstad , Are Hugo Pripp , Rebecka Dalbye , Aase Devold Pay , Anne Cathrine Staff , Anne Kaasen , Ellen Blix

引用次数: 0

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