Frontiers in global women's health最新文献

Background: Physical activity offers numerous health benefits and helps prevent various diseases, making it an essential component of a healthy lifestyle.

Objective: This study aims to examine the barriers and enablers that affect female participation in physical activity.

Methods: This was a cross-sectional quantitative study. The study questionnaire was adopted from a previous study. The survey was conducted online and completed by 668 Saudi women from across the country.

Results: The study findings regarding low physical activity levels among Saudi women are concerning, as 72.2% of participants were classified as sedentary or physically inactive. The study revealed that age, employment status, and income were significant factors affecting engagement of women in physical activity. Moreover, barriers such as expensive gym memberships, a lack of women-only clubs, a lack of enjoyment in sports, and prolonged use of the same exercise devices prevented Saudi women from participating in physical activities. However, women reported exercising to boost their self-satisfaction and self-confidence, thereby promoting overall health.

Conclusion: Saudi women exhibit a low level of physical activity. Barriers such as expensive gym memberships, a lack of women-only clubs, a lack of enjoyment in sports, prolonged use of the same exercise devices, and motivations related to self-satisfaction and self-confidence prevent Saudi women from practicing physical activities. Health system policymakers need to take action to increase physical activity levels and address these barriers.

Indigenous women experience distinctive mental health risks that accumulate across the life course under the continuing impacts of colonization, gendered violence, and systemic racism. Drawing on recent mandates from the United Nations Permanent Forum on Indigenous Issues and the World Health Assembly's Resolution 76.16 (2023), as well as community-based exemplars such as Partners In Health's women-led peer models, this policy brief applies the analytical dimensions of the National Collaborating Centre for Healthy Public Policy to synthesize evidence, contextual factors, and feasible policy options. It identifies disproportionate burdens in suicide rates, perinatal depression, caregiver stress, and menopausal symptom severity, alongside a persistent lack of validated Indigenous-specific screening tools and gender-disaggregated data. The brief recommends an integrated, rights-based strategy that funds Indigenous governance of culturally safe mental health services across the life course, builds an Indigenous Women's Mental Health Data Strategy grounded in data sovereignty, embeds traditional knowledge and place-anchored healing in coverage policies, and extends targeted support for caregiving and menopausal transitions. Implementing these measures would operationalize reconciliation commitments, reduce documented inequities, and generate long-term social and economic benefits for communities and health systems alike.

This paper explores the use of Housing First services for women experiencing homelessness, focusing on those aged 35 and over, who have multiple and complex needs. The paper draws on an evidence review and the results of a five-year evaluation of a Housing First for Women pilot project (2015-20) and three-year longitudinal study of two further Housing First services for Women in the UK (2021-24), which centred on the lived experience of women using these services. Four main arguments are advanced. The first is that the original Housing First model from the US and the initial deployments of the Housing First approach in Europe and the UK used a model designed in a context in which the nature and extent of middle aged and older women's homelessness was poorly understood. High fidelity Housing First services were less likely to be fully effective because the original model did not properly account for the level of trauma associated with domestic abuse and violence against women in middle age and later life. The second argument is that there is, on current and emergent evidence, a clear case for developing Housing First that is designed, managed and run by women for women which includes safeguarding as one of its key operating principles. The third argument is that Housing First for Women, with its comprehensive co-productive support and intensive case management, may offer important advantages over Sanctuary Schemes and other services that are designed to counteract middle aged and older women's homelessness that is associated with abuse, violence and multiple and complex needs. The paper concludes by arguing that in order to fully meet the needs of middle aged and older women experiencing long term and repeated homelessness with multiple and complex needs, an integrated and preventative strategy, including preventative approaches like Domestic Abuse Housing Alliance (DAHA) Accreditation and Housing First for Women must be developed. If Housing First for Women is to be effective, it must be situated within a wider integrated strategy to counteract women's homelessness to reach its full potential.

Background: Despite global advancements in reproductive healthcare, the utilization of modern contraceptives in Somalia remains critically low, marked by significant regional and sociodemographic disparities. This study assessed the prevalence and identified key predictors of modern contraceptive use among Somali women of reproductive age using data from the 2020 Somali Health and Demographic Survey (SHDS).

Methods: A nationally representative cross-sectional analysis was conducted on a sample of 2,704 women aged 15-49 years. Descriptive statistics and multivariable logistic regression were employed to identify factors associated with the use of modern contraceptives.

Results: The majority of participants were aged 26 years or older (57.6%), resided in urban areas (85.1%), and belonged to the highest wealth quintile (62.4%). The prevalence of modern contraceptive use among the study participants was exceptionally low at 1.8%. The most commonly reported methods were oral contraceptive pills (0.6%) and implants (0.2%), while the use of intrauterine devices (IUDs) was minimal (0.04%). A significant gap in exposure to family planning information was observed, with only 13.6% of women reported to have received it at health facilities. Key predictors for modern contraceptive use included the age of the women and exposure to family planning education at a health facility. Women aged 26 years and older demonstrated significantly higher odds of using contraception compared to their younger counterparts [adjusted odds ratio (AOR): 10.13; 95% confidence interval (CI): 2.39-42.97]. Furthermore, women who received family planning information from health facilities were twice as likely to use modern contraceptive methods (AOR: 1.99; 95% CI: 1.02-3.88).

Conclusion: The findings underscore an urgent need to enhance both the accessibility and knowledge of modern contraceptives in Somalia. Targeted interventions focusing on health facility-based education and expanding the limited variety of available contraceptive methods are crucial to improving uptake and addressing the reproductive health needs of Somali women.

Background: Obstetric violence is globally acknowledged as a significant public health concern, with women in many countries reporting different types of mistreatment during pregnancy, childbirth, and the postpartum period, that negatively affect their physical and emotional health. Many women are vulnerable to obstetric violenceand without knowledge about their rights, do not identify specific manifestations of violence.

Aim: This baseline study aimed to assess the current knowledge on obstetric violence in pregnant women and to determine possible associated factors in the central zone, Tanzania.

Methods: The baseline cross-sectional study was conducted on 349 randomly selected pregnant women between February and April 2025. A standard semi-structured questionnaire in a kobo tool box software was used to collect data on knowledge of obstetric violence and associated factors. Both descriptive and inferential analyses were conducted using SPSS software version 29.

Results: Overall, only 120(34.4%) of pregnant women had adequate knowledge of obstetric violence. The most commonly known components of obstetric violence were verbal 216(61.9%) and physical violence 211(60.5%). High levels of education, gravidity, and mobile phone usage for health-related issues were significantly associated with knowledge of obstetric violence. In addition, none of the pregnant woman reported being counselled about obstetric violence during their antenatal care.

Conclusion: This baseline assessment offers essential information regarding the current state of knowledge about obstetric violence among pregnant women. The absence of reported counseling about obstetric violence during antenatal care highlights a critical gap. The results highlight the necessity for selective educational initiatives to enhance women's knowledge and their rights during pregnancy, childbirth and after childbirth in promoting respectful maternity care.

Background: According to the WHO, violence is the intentional use of force or power against oneself, another person, or a community, causing injury, death, or harm. National data from 2021 reveal that as many as 70.1% of women in Mexico have experienced some form of violence. Pregnancy represents a period of heightened vulnerability, with negative impacts on material and infant health.

Material and methods: This cross-sectional observational study was conducted on women during the immediate postpartum period. Domestic violence was assessed using the Woman Abuse Screening Tool (WAST) scale, the Affective Bonding and Prenatal Adjustment Assessment Scale survey, and postpartum depression was evaluated through the Centre for Epidemiological Studies-Depression Scale (CES-D) scale.

Results: Four hundred women were included using the short version of the WAST scale, with 31.5% (126) testing positive for the screening questions. Women who experienced abuse showed higher odds of postpartum depression (OR = 2.95; 95% IC: 1.87-4.63; p = 0.000) and tobacco use (OR = 2.28; 95% IC: 1.31-3.94; p = 0.003). Adverse perinatal effects, such as preterm delivery (35.7%), admission to intensive care (40.5%), and low birth weight (19.8%), were frequent but without statistical significance.

Conclusions: One-third of the pregnant women in the study suffered intimate partner violence, mainly psychological and economic. Unwanted pregnancy, lack of emotional bonding, postpartum depression, alcohol/smoking, and low education levels were frequent factors.

Aim: Hepatitis B virus (HBV) infection during pregnancy is one of the most common comorbidities, which may increase the risk of adverse obstetric and perinatal outcomes. However, the association between maternal HBV infection and postpartum hemorrhage (PPH) remains uncertain. The aim of this study is to evaluate whether maternal HBV infection will increase the risk of PPH.

Methods: Five English and three Chinese databases were searched from inception to 30 June 2024, with the aim to include recently published eligible studies. Cohort and case-control studies that evaluated the association between maternal HBV infection and PPH were included. The Newcastle-Ottawa scale was used to evaluate the risk of bias for the included studies. We pooled crude relative risk (cRR) and adjusted odds ratio (aOR) as effect sizes. Three subgroup analyses and seven sensitivity analyses were performed.

Results: A total of 21 cohort studies involving 379,782 participants were included. The pooled results of the unadjusted data revealed that maternal HBV infection was associated with an increased risk of PPH [cRR = 1.18, 95% confidence interval (CI): 1.06-1.31]. Furthermore, the pooled results of adjusted data showed a similar risk of PPH (aOR = 1.50, 95% CI: 1.29-1.73). The effect was similar in three subgroup analyses (i.e., sample size, study region, and prevalence of HBV infection). Sensitivity analyses confirmed that the primary results were robust.

Conclusions: Maternal HBV infection is associated with an increased risk of PPH. Further studies are warranted to evaluate the impact of maternal HBeAg serostatus and HBV DNA levels on PPH.

Systematic review registration: identifier CRD42023442626.

Background: It is estimated that 13% of adolescent girls globally give birth before the age of 18. Several studies have shown that pre-eclampsia, eclampsia, puerperal infections, preterm birth, low birth weight, and neonatal death are more common in adolescent mothers than in adult mothers. This study aimed to investigate whether adolescent pregnancy increases the risk of adverse obstetric and perinatal outcomes compared with pregnancies among women aged 20-35 years in the West Bank, occupied Palestinian territory.

Methods: A retrospective cohort study utilizing data extracted from the electronic health information system database. The study population comprised 11,189 women who gave birth in three governmental hospitals in the West Bank during the year 2022, of whom 762 (6.8%) were aged ≤19 years. Differences between the two age groups were analyzed using chi-square test (χ ²) for categorical variables and independent student test for continuous variables. Multiple logistic regression and sensitivity analyses were performed to adjust for confounders and to examine the association between the adolescent age group and adverse obstetric and perinatal outcomes.

Results: Most adolescent mothers were primiparous (82.2%) and had a singleton pregnancy (98.2%). Adolescent mothers were more likely to experience preterm birth (aOR 1.568, CI 95% 1.262-1.949, p < 0.001) and low birth weight (aOR 1.657, CI 1.327-2.068, p < 0.001). Low Apgar score at first minute was demonstrated among primiparous adolescents (aOR 1.774, CI 1.149-2.737, p = 0.01). While adolescent primiparous mothers were less likely to deliver by cesarean section compared to older mothers (aOR 0.270, CI 0.212-0.342, p = 0.00), fetal malpresentation as an indication for cesarean section was higher among adolescents (aOR 2.150, CI 1.329-3.479, p = 0.002). No significant differences were observed between the two age groups in terms of gestational diabetes, hypertensive disorders, antepartum or postpartum hemorrhage, blood transfusion, induction of labor, instrumental delivery, five-minute Apgar score, admission to neonatal intensive care unit, neonatal malformation, or stillbirth.

Conclusion: Adolescent pregnancies should be classified as high-risk given their association with multiple adverse obstetric and perinatal outcomes. These findings underscore the need for policymakers to strengthen preventive strategies and to ensure strict enforcement of the child marriage prohibition law.

Background: Postpartum posttraumatic stress disorder (PTSD) occurs commonly in individuals after childbirth and is associated with adverse maternal and neonatal outcomes. The primary objective of this pilot study was to determine the acceptability and feasibility of administering glucocorticoids to reduce posttraumatic stress symptoms after a traumatic birth event.

Methods: This was a single-center, non-randomized, open-label pilot trial conducted at Michigan Medicine. Postpartum patients who screened positive for PTSD DSM-V Criterion A (felt a threat to life or injury to self or neonate) were enrolled. Participants self-selected to either (1) receive hydrocortisone within 12 h of the traumatic event or (2) defer hydrocortisone and remain in an observational control arm. Participants were assessed at the time of enrollment and multiple time points postpartum (days 3, 14, and 42) for posttraumatic stress symptoms using the City Birth Trauma Scale. The analysis compared the distribution of PTSD symptom scores in the intervention and control arms over time via weighted generalized estimating equations.

Results: Study recruitment was highly successful, with 133 of 138 eligible patients (96%) enrolled, and only 9 of 261 approached patients (3%) refused to be screened for study participation. Among participants who chose to receive hydrocortisone, the study drug was administered within 12 h of birth in all cases (20/20, 100%). For the primary clinical outcome, PTSD score, 127 participants were included in the longitudinal analysis; n = 19 self-selected to receive the hydrocortisone intervention, and n = 108 enrolled in the control arm. In the hydrocortisone arm, PTSD scores significantly increased from baseline to postpartum day 14 [6.29, 95% CI (0.36, 12.22), p = 0.038] and from baseline to postpartum day 42 [7.46, 95% CI (0.30, 14.61) p = 0.041] when compared with the control's change in PTSD scores from baseline to postpartum day 14 and from baseline to postpartum day 42.

Conclusions: These pilot findings demonstrate the acceptability and feasibility of enrolling obstetric patients into a pharmacologic clinical trial immediately postpartum. In those at high risk for PTSD, glucocorticoids did not decrease, and may have increased, PTSD symptomatology. Future larger and randomized trials are needed to confirm or refute these initial findings.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04852458, identifier, NCT04852458.

Introduction: There is limited research on disrupted maternal representations of the child, including possible mechanisms that may account for their impact on very young children's social-emotional well-being. Existing research suggests that maternal mental health symptoms, particularly those that may be related to experiences of interpersonal trauma, may be important to investigate.

Method: Utilizing multi-method data, including the Working Model of the Child Interview, from a longitudinal study involving a community sample (N = 120) of women aged 18-42 who participated from their third trimester of pregnancy through 2 years post birth, the present study examined associations between disrupted prenatal maternal representations, infant and toddler social-emotional functioning, and perinatal (third trimester and 1-year post birth) maternal mental health symptoms (PTSD, depression, and anxiety).

Results: Prenatal PTSD symptoms were the only maternal mental health symptoms significantly associated with degree of disrupted prenatal maternal representations and later infant and toddler social-emotional functioning. Mediation models revealed that maternal prenatal PTSD symptoms mediated the association between degree of disrupted prenatal maternal representations and infant, but not toddler, social-emotional functioning.

Discussion: Findings highlight the importance of screening for maternal PTSD symptoms during the prenatal period as well as the value of early intervention when disrupted prenatal maternal representations are identified.