Frontiers in global women's health最新文献

Introduction: Limited studies have assessed the accuracy of mid-upper arm circumference (MUAC) in diagnosing nutritional status among pregnant women in Sub-Saharan Africa, and none in Rwanda. This study aimed to evaluate the effectiveness of MUAC in detecting obesity among pregnant women at Kacyiru Hospital in Kigali, Rwanda.

Methods: This cross-sectional study was conducted at Kacyiru Hospital, a district hospital in Kigali, Rwanda. Standard procedures were used to measure MUAC, weight, and height, from which body mass index (BMI) was calculated. Receiver operating characteristic (ROC) curves were created to determine cutoff points using Youden's index (YI).

Results: A total of 689 women were enrolled. The median (interquartile range) age and gravidity were 29.0 (26.0-33.0) years and 2 (1-3), respectively. Among the 592 women (85.9%) with gestational ages of ≥20.0 weeks, 5 (0.7%) were underweight and 195 (28.3%) were obese. There was a significant correlation between BMI and MUAC (r = 0.78) across all women and within the early (r = 0.774) and late pregnancy subgroups. The optimal MUAC cutoff for detecting obesity (BMI ≥ 30.0 kg/m²) was ≥27.5 cm in both early and late pregnancies (YI = 0.58, sensitivity = 0.91, specificity = 0.67), with a high predictive value [area under the receiver operating characteristic curve (AUROCC) = 0.88, 95% confidence interval (CI) = 0.85-0.90]. In early pregnancy, the best MUAC cutoff was ≥29.5 cm (YI = 0.73, sensitivity = 0.92, specificity = 0.80), with a high predictive value (AUROCC = 0.87, 95% CI = 0.77-0.97). In late pregnancy, the best MUAC cutoff was ≥27.5 cm (YI = 0.62, sensitivity = 0.92, specificity = 0.71), with a high predictive value (AUROCC = 0.89, 95% CI = 0.87-0.92).

Conclusion: MUAC is a reliable indicator for detecting obesity in pregnant women. Further research with larger sample sizes and follow-up studies is needed to assess MUAC's ability to detect underweight status and related adverse pregnancy effects.

Background: Maternal health remains a critical public health priority, particularly in low- and middle-income countries where maternal mortality rates are alarmingly high. Early antenatal care (ANC) initiation within the first trimester is essential for identifying and managing potential health risks for both mothers and their babies. Despite global efforts to promote early ANC, significant disparities persist, especially in Nigeria. This study investigates the sociodemographic determinants and regional disparities influencing the timing of ANC initiation among Nigerian women.

Methods: This study utilized data from the 2018 Nigeria Demographic and Health Survey (NDHS), analyzing a sample of 16,542 women aged 15-49 who had given birth within five years of the survey. A multivariable multilevel logistic regression model was employed to assess the impact of individual and community-level factors on early ANC initiation. The model accounted for regional clustering to identify the most significant predictors of first-trimester ANC contact.

Results: The analysis revealed that only 24.0% (n = 3,970) of Nigerian women-initiated ANC in the first trimester, with substantial regional disparities. The South West region had the highest prevalence (34.5%, n = 1,045), while the North West region had the lowest (12.5%, n = 609). Multivariable analysis showed that women with higher education were nearly twice as likely to initiate ANC early (AOR = 1.98, 95% CI: 1.65-2.37). Muslim women had lower odds of early ANC initiation than Catholics (AOR = 0.64, 95% CI: 0.47-0.87). Wealthier women had a significantly higher likelihood of early ANC, with the richest women being nearly three times more likely than the poorest (AOR = 2.88, 95% CI: 2.49-3.33). The final multilevel model showed a reduced intraclass correlation coefficient (ICC) of 2.6%, indicating that regional variation in ANC initiation.

Conclusion: The findings highlight significant sociodemographic and regional disparities in the timing of ANC initiation among Nigerian women. To improve early ANC uptake, targeted interventions that address both individual barriers, such as education and economic status, and broader regional disparities are essential.

Introduction: Perinatal individuals are at an increased risk of experiencing psychological distress, which often manifests in a combination of co-occurring symptoms of anxiety, depression, and stress. During the COVID-19 pandemic, the rates of psychological distress experienced by perinatal women dramatically increased, in some cases doubling or even tripling. This increase is concerning as psychological distress can impact the health and wellbeing of mothers and their offspring, including an offspring's neurocognitive, physical, mental, and socio-emotional development. The strategies a perinatal individual uses to cope with psychological distress are modifiable and, therefore, can be targeted to help improve outcomes for mothers and their offspring.

Methods: This rapid review describes and synthesizes the literature related to coping with perinatal psychological distress during the COVID-19 pandemic. This review included twenty-four cross-sectional studies.

Results: Perinatal individuals reported using various coping strategies to deal with the COVID-19 pandemic, including social strategies (e.g., connecting with others); physical strategies (e.g., exercising); cognitive strategies (e.g., positive re-appraisal); and spiritual strategies (e.g., prayer). An avoidant style of coping and its accompanying behaviours, including disengagement, substance use, and distraction via screen time/social media use, were significantly associated with higher levels of psychological distress. Strategies associated with lower levels of psychological distress included sleep and social support.

Discussion: Future studies should address the impact of technology on coping and the long-term impact of coping styles used during the COVID-19 pandemic on the wellbeing of mothers and their offspring. Although this rapid review centered on the COVID-19 context, its findings are broadly relevant to women worldwide who continue to experience prolonged stressors such as climate change, poverty, and conflict.

Women are underrepresented globally in the field of data analytics, particularly in underdeveloped countries. We present a protocol to assess the impact of the New Dimensions program, a data analytics and business intelligence course sequence that aims to address this gender gap by providing free business intelligence training to disadvantaged women in Ecuador. The program offers both technical (Business Intelligence) and soft skills training, including Excel, Power BI, SQL, GitHub, R, Tableau, statistics, Python, and workshops on empowerment, employability, and public speech. The purpose of this quasi-experimental study is to assess the impact of this training program on employability and other well-being outcomes of the participants. A total of 80 individuals will be part in the study, of which 70 will be selected to participate in the program, 50 will receive both hard and soft skills training, and 20 only soft skills training. Ten individuals will form part of the control group with no intervention. The study design involves a nonrandomized control group composed of rejected applicants. Data will be collected through an online application form and a computer-based exam. The outcome measures are participants' labor market outcomes, income, food security, and economic stratification, among others. This protocol will prospectively evaluate the program's potential effectiveness; findings will inform future, larger randomized studies focused on employability and well-being in underrepresented groups.

Background: Mistreatment of women during childbirth in healthcare facilities can serve as a barrier to utilizing healthcare services. Respectful maternity care (RMC) has been recommended to address this issue, and interventions to promote RMC have been implemented globally. For Indigenous women in particular, such care is closely related to childbirth satisfaction and is considered crucial. However, research on RMC in Guatemala is limited, with no reports focusing on educational interventions. Therefore, this study aimed to implement an educational program to promote RMC for nurses and evaluate its effectiveness.

Methods: This study employed a quasi-experimental design and was conducted at a hospital in the Quiché Department, Guatemala. For nurses in the hospital, a two-day educational program on RMC, which included lectures and group work, was implemented. The effectiveness of the program was assessed by comparing women's experiences of RMC and mistreatment during childbirth before and after the intervention. Data was analyzed using chi-square tests, independent t-tests, and ANCOVA.

Results: This study included 176 postpartum women, with 88 in each pre- and post-intervention group. The average RMC scores significantly increased from 33.74 pre-intervention to 56.70 post-intervention (p < .001), representing a 68% relative increase. In the pre-intervention group, 71.6% of women experienced physical abuse, verbal abuse, or stigma or discrimination, which significantly decreased to 33.0% in the post-intervention group (p < .001).

Conclusion: This educational program suggested improvements in women's childbirth experiences in the facility. Implementing this program in other facilities and regions could contribute to the widespread promotion of RMC practices in healthcare settings.

Background: Eclampsia and pre-eclampsia cause high feto-maternal mortality in Pakistan. This study aimed to identify potential risk factors in pregnant women that can lead to the development of eclampsia and pre-eclampsia.

Methods: A cross-sectional study was conducted in the BVH, Bahawalpur (July 2021-December 2022), to record socio-demographic information, risk factors, clinical symptoms, and treatment administered, which was linked with maternal and neonatal outcomes. The Chi-squared test was applied to describe the relation in categorical variables. Odds ratio were calculated by binary logistic regression for normally distributed significant values.

Results: A total of 85 women with eclampsia and 43 with pre-eclampsia were included in the study. The eclamptic women showed a higher rate of illiteracy, were overweight, and married to their cousins. They presented with high systolic blood pressure, proteinuria, and low platelet count (OR = 7.24, 95% CI = 1.60-32.68, p = 0.01), increased respiratory rate, and elevated AST, ALT, and LDH levels at the time of diagnosis. Women administered with MgSO₄ 10 g/day (48.5% survived vs. 77.4% non-survived) showed high perinatal mortality compared to a 4 g/day dose (30.9% survived vs. 16.1% non-survived) or those who hadn't received magnesium sulfate (20.6% survived vs. 6.5% non-survived).

Conclusion: Advanced maternal age (≥35), overweight, elevated AST, ALT, and LDH levels, consanguinity, and grand multiparity were associated with higher perinatal mortality. Women with these predictive factors should be monitored for the development of pre-eclampsia or eclampsia.

Background: Skeletal muscle serves as the primary source of power for body movement. Due to the transition of menopause, older women experience a relatively faster decline in skeletal muscle mass and function, making them more susceptible to age-related skeletal muscle disorders such as sarcopenia, which can lead to adverse outcomes such as falls, fractures, disability, or even death. Blood flow restriction low-intensity resistance training (LI-BFRT) can effectively enhance muscle strength and promote skeletal muscle growth, while repetitive transcranial magnetic stimulation (rTMS) has previously been shown to improve motor cortex excitability and limb motor function. We describe a trial protocol to investigate the effects of a 12-week intervention combining rTMS with LI-BFRT on skeletal muscle mass and physical function in community-dwelling postmenopausal women.

Methods: This single-blind, randomized controlled trial will recruit 54 eligible community-dwelling postmenopausal women aged 50-65 years who have been naturally postmenopausal for 1 year or more. Participants will be randomly assigned in a 1:1:1 ratio to the rTMS combined with the blood flow restriction low-intensity resistance training group (rTMS + LI-BFRT), the blood flow restriction low-intensity resistance training group (LI-BFRT), and the control group, respectively, for a 12-week intervention period. Participants will undergo assessments at baseline (Week 0), immediately after the intervention (Week 12), and long-term follow-up (Week 24). The primary outcomes include lower limb muscle mass, muscle strength in both the upper and lower limbs; secondary outcomes include body composition, physical function (5-time sit-to-stand test, 30-second stand test, timed up-and-go test, 30-second arm curl test), motor cortex excitability, and clinical blood markers related to neural and muscular function.

Discussion: We have combined central and peripheral motor activation methods for the first time, attempting to use BFRT in combination with rTMS intervention to recruit more motor units by increasing motor cortex excitability, thereby enhancing skeletal muscle motor ability under BFRT and examining the intervention effects on skeletal muscle mass and strength in postmenopausal women. This will provide a new paradigm for healthy intervention in the skeletal muscles of postmenopausal women.

Clinical trial registration: http://www.chictr.org.cn, Chinese Clinical Trial Registry ChiCTR2400086697.

Objective: To explore and analyze the current research status, hotspots, and development trend of labor and delivery experience, to provide a reference for subsequent related research and clinical practice.

Methods: We searched the Web of Science database for literature related to labor and delivery experience published between its establishment and December 20, 2024, and conducted bibliometric analysis using CiteSpace software.

Results: After screening, 1089 papers were included in the analysis, and the number of annual publications showed a growing trend, reaching its highest in 2024. The United States and Sweden dominated the list. The research hotspots focused on maternal mental health, delivery methods, and quality of Intrapartum care.

Conclusion: The field of birth experiences is currently undergoing rapid development, with leading trends including innovations in delivery methods, prenatal care, research in the cognitive neuroscience of childbirth, and a focus on mothers undergoing induced labor and those in low-income areas to optimize the overall birth experience.

Introduction: Depression and anxiety are leading contributors to the global burden of disease among women yet help-seeking for mental health concerns remains limited in lower-middle-income countries. This study aimed to estimate the prevalence of anxiety, depression, and help-seeking behaviors, and to identify factors associated with the absence of help-seeking among ever-married women of reproductive age in Bangladesh.

Methods: We conducted a cross-sectional analysis using nationally representative data from the 2022 Bangladesh Demographic and Health Survey. Mental health outcomes were assessed using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 screening tools. Help-seeking behavior was defined as any attempt to obtain external support for mental health concerns. Multivariable logistic regression models, accounting for survey design and sampling weights, were used to examine predictors of not seeking help following Behavioral Model of Health Services Use by Andersen and Davidson.

Results: Among 19,987 women aged 15-49 years, 5.1% reported depression, 19.7% reported anxiety, and 20.4% had either condition. Only 20.5% of those with anxiety or depression reported help-seeking, predominantly from informal sources such as family and neighbors. Rural residence, older age, and a professional diagnosis of anxiety were associated with increased help-seeking, while low health autonomy and residence in the Barishal division were linked to lower help-seeking. Formal help-seeking was rare, and significant regional disparities were observed. One in five ever-married women of reproductive age in Bangladesh experiences anxiety or depression, but help-seeking remains low, especially for formal services.

Discussion: Informal networks play a critical role in support. Interventions should address contextual and individual barriers, strengthen social support, and improve access to mental health care, particularly in underserved regions.

[This corrects the article DOI: 10.3389/fgwh.2025.1590414.].