Frontiers in global women's health最新文献

Introduction: Women identified at risk for preterm may be vulnerable to developing mental health difficulties due to the increased likelihood of poor pregnancy outcome and uncertainty surrounding their delivery. Formal assessment of mental wellbeing in specialist preterm birth clinics is not routinely offered, but may offer the opportunity for early intervention.

Methods: We aimed to investigate if demographic characteristics and obstetric risk factors were associated with psychological wellbeing in women at risk of preterm birth. We explored associations between mental wellbeing and risk factors for preterm birth using hierarchical regression analyses.

Results: When demographic variables were considered alone, high body mass index (BMI) was significantly associated with anxiety (p = .026), however became non-significant when obstetric risk factors were also considered. Previous late miscarriage was associated with high anxiety (p = .049). Lower maternal age at estimated date of delivery (p = .019) and non-European ethnic heritage (p = .029) were significantly associated with depression. High maternal BMI (p < .001), being of any other non-European ethnic heritage (p = .043), currently smoking (p = .002), and previous spontaneous preterm birth (p = .017) were associated with lower perceived wellbeing.

Discussion: The results of this study highlight the importance of routinely monitoring mental health in women with relevant risk factors, particularly if they are already at risk of preterm birth.

Rationale: Over 11 million people in the United States provide care for an older family member with dementia, with this responsibility primarily falling on daughters and wives. In Appalachia, a mountainous region in the U.S characterized by close families, family members were crucial to ensuring that care needs were met for people living with dementia during the COVID-19 pandemic. However, we know little about the well-being of family caregivers during the public health crisis. Guided by a Limited Future Time Perspective postulate, which posits that as people age they begin to prioritize emotionally meaningful relationships over instrumental goals, we asked how dementia caregiving changes the social lives of family caregivers situated within kin networks; and how a public health crisis (i.e., COVID-19 pandemic) affects caregivers who are already at risk for social isolation and feelings of loneliness.

Methods: Participants were recruited from a regional health care system and four Area Agencies on Aging. In our longitudinal study we invited family caregivers to be interviewed at multiple time points over a 4-year period. The sample for this study was women caregivers interviewed (N = 27; age range 32-81, m = 63). Interviewers followed a semi-structured protocol with questions designed to elicit descriptions about (a) changes in formal and informal support over time, (b) the person living with dementia's symptoms and disease progression, and (c) how the pandemic affected caregivers' and persons living with dementia's social worlds.

Findings: We found three types of caregivers: (1) caregivers who had social lives interdependent with their relative with dementia, (2) caregivers and persons living with dementia whose social lives were restricted due to dementia symptoms and caregiving demands, and (3) caregivers and their relative living with dementia who maintained separate social lives. Dementia symptoms more than social distancing measures contributed to caregivers' shrinking social worlds particularly for those with interdependent social lives despite living amongst kin.

Conclusions: This study is important in understanding how women in Appalachia fared during a pandemic in the context of dementia caregiving. This research supports the need for respite services and dementia care training for respite workers.

Background: Conflict is known to impact maternal and neonatal health in Eastern Democratic Republic of the Congo (DRC), an area of longstanding insecurity. We conducted a systematic review on pregnancy and neonatal outcomes in this region to provide a comprehensive overview of maternal and neonatal outcomes over a 20-year period.

Methods: We systematically searched databases, such as Medline, EMBASE, Global Health, ClinicalTrials.gov and the Cochrane Library, along with grey literature, for articles published between 2001 and 2021. These articles provided quantitative data on selected pregnancy and neonatal outcomes in the provinces of Ituri, Maniema and North and South Kivu, Eastern DRC. We conducted a descriptive analysis, combining results from different data sources and comparing incidence of outcomes in North Kivu with those in other provinces in Eastern DRC.

Results: A total of 1,065 abstracts from peer-reviewed publications and 196 articles from the grey literature were screened, resulting in the inclusion of 14 scientific articles in the review. The most frequently reported pregnancy complications were caesarean sections (11.6%-48.3% of deliveries) and miscarriage (1.2%-30.0% of deliveries). The most common neonatal outcomes were low birth weight (3.8%-21.9% of live births), preterm birth (0.9%-74.0%) and neonatal death (0.2%-43.3%).

Conclusion: Our review provides data on pregnancy and neonatal outcomes in Eastern DRC, which will be valuable for future studies. Despite the area's ongoing armed conflict, the percentages of complications we noted in Eastern DRC are comparable with those observed in other countries in the region.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=262553, PROSPERO (CRD42021262553).

Aim: There are limited studies in Tanzania concerning the modality of preparing patient navigators and the influence of patient navigation strategies on cervical cancer screening. This protocol describes the preparation of patient navigators and assesses the impact of a patient navigation strategy on promoting cervical cancer screening uptake, knowledge, awareness, intention, and health beliefs.

Design: This is a protocol for a community-based randomized controlled trial.

Methods: The method is categorized into two phases. (1) Preparing patient navigators, which will involve the training of five patient navigators guided by a validated training manual. The training will be conducted over three consecutive days, covering the basic concepts of cervical cancer screening and guiding navigators on how to implement a patient navigation strategy in the communities. (2) Delivering a patient navigation intervention to community women (COMW) which will involve health education, screening appointments, navigation services, and counseling. The study will recruit 202 COMW who will be randomized 1:1 by computer-based blocks to either the patient navigation intervention group or the control group.

Public contribution: The study will prove that the trained patient navigators are easily accessible and offer timely and culturally acceptable services to promote cervical cancer screening uptake in communities.

Background: Coronavirus Disease-19 pandemic had an adverse impact on the mental health of the public worldwide, but the problem is worst among pregnant women due to social distancing policies and mandatory lockdown, including prenatal care services. As a result, the prevalence of depression and anxiety could increase during the pandemic, particularly among pregnant women. Thus, the purpose of this review is to determine the magnitude of depression and anxiety and contributing factors among pregnant women during the pandemic in Ethiopia.

Methods: Web of Science, Since Direct, PubMed, Google Scholar, and African Journals Online were the electronic databases searched, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed in this review. The Newcastle-Ottawa Critical Appraisal Checklist was used to assess the quality of the included studies. A predefined data extraction sheet developed in Excel was used to extract the data. The pooled prevalence of anxiety and depression was determined by a random effect model meta-analysis.

Results: 4,269 and 1,672 pregnant women were involved in depression and anxiety studies, respectively. The pooled prevalence of depression and anxiety among pregnant women during the COVID-19 pandemic in Ethiopia was 24.7% (95% CI: 18.52-30.87) and 35.19% (95% CI: 26.83-43.55), respectively. Single marital status (AOR = 2.22, 95% CI: 1.07-3.37), poor social support (AOR = 2.7, 95% CI: 1.06-4.35), unplanned pregnancies (AOR = 2.17, 95% CI: 1.34-3.0), and unsatisfied marital status (AOR = 2.16, 95% CI: 1.17-3.14) were risk factors for depression. Violence against intimate partners (AOR = 2.87, 95% CI: 1.97-3.77) and poor social support (AOR = 1.98, 95% CI: 1.24-2.71) were risk factors for anxiety.

Conclusion: One-fourth and nearly one-third of pregnant women had depression and anxiety, respectively, during COVID-19 pandemic in Ethiopia. Single or unsatisfied marital status and unplanned pregnancies were risk factors for depression. Poor social support was significantly associated with depression and anxiety. Pregnant women who experienced violence against intimate partners had higher anxiety. After COVID-19 pandemic, mental health interventions are essential for reducing depression and anxiety.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=527148, PROSPERO (CRD42024527148).

Background: Endometriosis, impacting roughly 10% of reproductive-age women and girls globally, presents diagnostic challenges that can cause significant delays between symptom onset and medical confirmation. The aim of the current study was to explore the experience of women with endometriosis as well as that of their partners, from pre-diagnosis to diagnosis to post-diagnosis.

Methods: In-depth semi-structured interviews were conducted with 10 couples coping with endometriosis. Each partner was interviewed separately, and each interview was analyzed both individually and as part of a dyad, using the dyadic interview analysis method.

Results: Three main themes emerged: (i) "Relationship in the shadow of uncertainty": Coping with health symptoms prior to the formal endometriosis diagnosis; (ii) Coping together or alone when receiving the endometriosis diagnosis; and (iii) "The day after the diagnosis": Moving between adversity and growth.

Conclusions: The study's findings emphasize the importance of viewing the diagnosis from a dyadic perspective and comprehensively - that is, from pre-diagnosis to accepting the formal diagnosis to post-diagnosis. This journey can have a profound impact on both couple members, affecting their day-to-day functioning, communication, emotional and physical intimacy, and fertility.

Background: Studies on lower urinary tract symptoms (LUTS) in women, especially in relation to different modes of delivery, are limited. The relationship between the emergence of LUTS and the decline of pelvic muscle function after childbirth remains uncertain.

Study design: This observational study was carried out at the Peking University First Hospital over a time span of 2019-2022. A total of 2,462 women were recruited and surveyed 6 weeks after delivery, utilizing questionnaires for data collection. Additionally, gynecological physical examinations and pelvic floor muscle screenings were conducted as part of the study. To assess individual LUTS and the level of discomfort caused by these symptoms, a modified Chinese version of the Bristol Female Lower Urinary Tract Symptoms questionnaire was employed. Data analysis methods such as descriptive statistics, χ ² tests, one-way ANOVAs, and multivariate logistic regressions were used to thoroughly examine the collected data.

Results: A high prevalence of LUTS was observed in the study participants, with 70.6% experiencing any symptoms. Storage symptoms were reported by 65.4%, while voiding symptoms were reported by 23.0%. Nocturia was the most commonly reported symptom (35.4%), followed by frequency (25.6%) and urgency (25.3%). Stress urinary incontinence (SUI) was reported by 20.8% of women. Interestingly, nocturia and frequency were generally perceived as less troublesome, with only a minority rating them as problematic. In contrast, urinary incontinence (UI) was frequently reported as highly bothersome, with SUI and urge urinary incontinence (UUI) accounting for significant proportions. Vaginal delivery (VD) and forceps delivery (FD) were identified as significant predictors of LUTS, with statistical significance observed (P < 0.05). Specifically, women who underwent VD, particularly FD, exhibited lower surface electromyography (sEMG) activity compared to those who had cesarean section (CS), both in terms of resting baseline and contraction amplitude (P < 0.001).

Conclusions: Over half of the examined women exhibited LUTS 6 weeks postpartum, with the most common symptoms being nocturia, frequency, urgency, and SUI. Straining and urinary incontinence were commonly reported as significantly uncomfortable, particularly severe in cases of UI. Additionally, vaginal delivery methods, especially those involving the use of forceps (FD), seemed to be more likely to cause pelvic floor muscle or nerve damage, making it the key predictor of storage-related LUTS.

Background: Polycystic ovary syndrome (PCOS), a common endocrine disorder, affects women of reproductive age, and its adverse consequences affect women throughout their lifespan, from adolescence to postmenopause. The prevalence of depression is much higher in women with PCOS than in healthy controls. Thus, it is recommended that depressive syndrome be screened routinely in all patients with PCOS at diagnosis. To date, no comprehensive bibliometric analysis has been conducted in this field. Therefore, we conducted a bibliometric analysis to describe the current status, trends, and hotspots of PCOS research related to depression.

Materials and methods: Using data retrieved from the Web of Science (WoS) Core Collection database from 1993 to 2024, bibliometric analyses were performed using WoS and CiteSpace software.

Results: Since the first paper was published in 1993, studies related to PCOS and depression have remained rare in the following decade. Since the establishment of the Rotterdam criteria in 2003, research on the etiology, pathogenesis, and treatment of PCOS with depressive syndrome has entered a booming period. The United States and Australia indisputably took leading positions in this area, with the most outstanding institutions in the world being the University of Pennsylvania and Monash University. Although achievements have flourished since 2003, the exact pathogenesis of PCOS remains uncertain owing to its heterogeneity. New research is rapidly increasing to fill these gaps and to push forward the goal of improving the quality of life in women with PCOS and depression. Along with progress in research, the world's leading societies organize conferences every 5 years to update guidelines for the assessment and management of PCOS. "Oxidative stress," "inflammation," "obstructive sleep apnea," "gut microbiota," and "single nucleotide polymorphism" appeared as new hotspots in the recent 5 years.

Conclusion: A bibliometric analysis was performed to describe the trends and hotspots of research in women with PCOS and depression to attract the attention of more researchers to this topic.

Systematic review registration: https://www.webofscience.com/wos/woscc/basic-search.

Problem and background: During the COVID-19 pandemic, there was substantial reconfiguration of maternity care services, affecting both users and healthcare providers (HCPs), in the United Kingdom (UK) and globally.

Aim: To further our understanding of the impact of maternity service reconfigurations in the UK, from the perspective of maternity HCPs.

Methods: Scopus, MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane COVID Study Register were searched for relevant studies reporting qualitative data from the UK, published in English between 01 June 2021 and 30 September 2023. Qualitative data on HCPs' experiences of maternity care reconfiguration during the pandemic were extracted from 15 studies. Data were subjected to thematic synthesis according to key service reconfigurations.

Results: Nine themes were identified: Care-seeking and Care Experience: Changes to existing care, Limitations placed on the partner, Mental health and lack of support networks, and Barriers to successful implementation of reconfiguration strategies; Virtual Care: Impact on quality of care, Increased convenience and flexibility, and Digital exclusion; and Ethical Future of Maternity Care Services: Optimising patient care, and Service users and staff as the driving force for change. No studies reported on the concepts of Self-monitoring or COVID-19 vaccination.

Discussion and conclusion: The review findings highlight HCPs' views of the need for greater inclusion of partners, choice of virtual or in-person care for women and birthing people; and a need for co-designed services for future policy-making.

Introduction: The gender disparities and inequities faced by women in academia are widespread, especially in low- and middle-income countries (LMICs). The scholarly output of women scientists remains significantly lower than that of men due to limited opportunities. This widening gap has significant implications for policy-making and prioritizing agendas. The Supporting Women in Science (SWIS) programme aims to address these barriers by enhancing research capacity among early- and mid-career women scientists from LMIC regions such as South-Central Asia and East Africa, in bespoke areas of health and health-related sustainable development goals (HHSDGs).

Methods: The SWIS programme utilizes online and distance learning with a self-paced approach. Applications are accepted on a rolling basis, through a pre-defined eligibility criterion. Phase I involves online self-learning courses covering a core and elective curriculum over 6 months which is then evaluated in Phase II. Eligible candidates then move to Phase III, a mentored fellowship where they develop research proposals and receive funding for research project development, implementation, and evaluation. The rigorous reporting and monitoring mechanisms track compliance and progress. The online format, offered at no cost, enhances program accessibility, particularly in the post-COVID era. Additionally, SWIS prioritizes mentorship by selecting experienced professionals with strong research backgrounds and mentorship skills to guide participants. The programme evaluation will be based on selected success metrics including program completion ratio, funding opportunities availed by the participants, and generated scholarly output and presentations at key events.

Discussion and conclusion: Securing grant funding is pivotal for career advancement, yet women applicants face greater challenges as compared to men. The SWIS programme not only equips participants with knowledge and skills but also facilitates practical application through a simulated process, enabling participants to pursue future funding opportunities. Capacity-building initiatives like SWIS are crucial interventions to empower women scientists, foster equitable representation in academia, and create inclusive research environments and the programme acts as a steppingstone for future global leaders.