Women's health (London, England)最新文献

Quantifying women's empowerment has gained prominence as a research focus globally. We conducted a systematic review of the literature examining the measurement of women's empowerment in sub-Saharan Africa (SSA). The objectives of the study is to describe quantitative measurements of women's empowerment based on individual-level data. We searched PubMed/Medline, Scopus and ScienceDirect databases, along with forward and backward citation tracking, for studies published between 2010 and 2025. The search yielded 1898 records, of which 98 studies met the inclusion criteria. All included studies were peer-reviewed, conducted either across multiple countries or within specific national contexts and analysed data from women of reproductive age. The review revealed considerable variations in the definition of women's empowerment indicators, the conceptualization of dimensions and a general lack of consensus regarding what specific indicators were intending to measure. This review offers a comprehensive synthesis of the existing quantitative evidence on women's empowerment measurement in SSA. Furthermore, the findings underscore that empowerment is inherently multidimensional, encompassing aspects such as women's decision-making, control over resources and autonomy in sexual and reproductive matters. Importantly, the selection of dimensions and indicators is often constrained by the availability of relevant data.

Over the last several years, there has been a significant development in the utilization of robotics in gynecology and reproductive medicine. Robotic surgery offers several technical advantages over conventional laparoscopy, including stable and highly magnified 3D vision, enhanced hand-eye coordination, a surgeon-controlled field, optimized ergonomics, motion scaling, and physiological tremor filtering. Women's Health has solicited and published articles as part of a special collection aiming to focus on the current progress of robotics in gynecology and reproductive medicine. In this interesting and innovative issue, three articles were published: one editorial and two retrospective studies.

Background: Postpartum physical activity (PA) is crucial in supporting maternal health, contributing to mental health and well-being, weight management, and overall physical fitness. Although multiple health organizations have issued PA recommendations for postpartum women, the content and quality of these guidelines have not yet been systematically evaluated.

Objectives: To evaluate the quality of published guidelines on PA for postpartum women and to summarize their recommendations to provide clearer guidance for healthcare providers and postpartum women.

Design: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources and methods: Six electronic databases were searched for guidelines related to PA for postpartum women. Gray literature was also reviewed. Guidelines were included if they were developed by recognized health organizations, provided PA (including structured supervised exercises) recommendations for postpartum women, and were published or updated within the last 10 years. Data extraction and quality appraisal were independently conducted by pairs of reviewers using the Appraisal of Guidelines Research and Evaluation Tool (AGREE II).

Results: Eighteen guidelines were included, with AGREE II scores ranging from 50% to 92%. Seven guidelines (39%) met the criteria for satisfactory methodological quality. Most guidelines recommended that postpartum women engage in at least 150 min of moderate-intensity aerobic PA per week, while the 2025 Canadian guideline supports a minimum of 120 min based on meta-analytic evidence. Common recommendations included pelvic floor muscle training, strengthening exercises, and other exercises, with advice to seek healthcare guidance for women with special conditions.

Conclusion: There is a universal agreement across guidelines that postpartum women should aim for at least 120-150 min of moderate-intensity PA weekly. Future research should strengthen the evidence for specific types of PA, delivery mode considerations, and implementation strategies.

Registration: International Prospective Register of Systematic Reviews: PROSPERO (CRD42023447331).

Background: Veterans using Department of Veterans Affairs (VA) healthcare have a high burden of pre-pregnancy chronic disease that likely contributes to the observed high rate of pregnancy-related morbidity. Many common diseases frequently co-occur; understanding patterns of multimorbidity may inform the design and delivery of pre-pregnancy interventions to lower pregnancy morbidity risk.

Objective: The current study sought to identify patterns of co-occurrence of pre-pregnancy chronic disease among Veterans.

Design: We conducted a retrospective cohort study using VA administrative data.

Methods: Our population included Veterans ages 18-45 with ⩾1 pregnancy outcome (ectopic, spontaneous abortion, stillbirth, and/or live birth) during fiscal years 2010-2019. Presence of common chronic diseases with implications for pregnancy was detected using encounter International Classification of Diseases, 9th and 10th Revision (ICD-9 and ICD-10) codes in the 2 years prior to pregnancy. Patients were grouped based on latent class models of diagnosis patterns; two to seven latent groups were examined for model fit and clinical interpretability.

Results: We identified 56,853 pregnancies from 41,034 Veterans. More than half of pregnancies were complicated by an array of pre-pregnancy medical and mental health conditions that may negatively impact pregnancy health and contribute to adverse pregnancy outcomes. The most frequently occurring conditions included chronic pain (51.2% of pregnancies), depression (31.4%), anxiety (25.9%), and post-traumatic stress disorder (22.8%). A five-group model demonstrated the best balance between model fit and clinical interpretability. Groups included: "Pain and Mental Health" (28%), with high prevalence of chronic pain, depression, and anxiety; "Pain and Metabolic" (17%), high prevalence of chronic pain, obesity, and migraines; "Substance Use and Mental Health" (7%), high prevalence of alcohol use disorder, depression, and post-traumatic stress disorder; "Low Diagnosis" (43%), lower than average prevalence of diagnoses; and "High Complexity" (5%), high prevalence of conditions across multiple physiologic systems.

Conclusions: We identified five distinct, clinically meaningful groups of Veterans based on co-occurring pre-pregnancy diseases. Tailoring interventions to these groups may address Veterans' complex pre-pregnancy health risks effectively and efficiently.

Background: Driven by structural violence experienced during forced migration, including asylum-deterrence policies, asylum-seeking women face health and social inequities related to experiences of pregnancy and motherhood. Little is known about the intersecting relationships between forced migration and motherhood and their respective health consequences.

Objectives: This study examined the interplay between the structural constraints and the individual agency on pregnant and parenting asylum-seeking women's sexual, reproductive, and mental health and migration experiences.

Design: Qualitative.

Methods: As part of a community-academic partnership, we thematically analyzed 38 qualitative, semi-structured interviews conducted in Spanish or Haitian Creole with pregnant and parenting asylum-seeking women at the Mexico-US border (July 2022 to April 2023).

Results: Structural violence and agency intersected to affect migrant women's experiences of pregnancy and motherhood. The structural violence experienced during forced migration, including political, legal, and economic violence, constrained women's sexual, reproductive, and mental health during pregnancy and motherhood via barriers to family planning; reduced/delayed access to perinatal care; food, housing, and economic insecurity; and psychosocial stressors (e.g., anxiety around family separation). Concomitantly, women's identity as mothers was a source of agency and resilience amidst forced migration, leading to shifts in migration trajectories and strengthened resolve to build a safer life for their children.

Conclusion: Asylum-seeking women faced barriers to healthy pregnancy and motherhood during migration, influenced by structural constraints during forced migration and tempered by their strength and resilience as mothers. There is a need for removal of restrictive immigration policies to address the harmful socio-structural contexts that perpetuate adverse health outcomes among women and their families during forced migration, alongside humanitarian and health services for asylum-seeking women that acknowledge the impacts of structural violence amid current migration policies.

Background: Due to minimal effects, new directions for behavioral (non-pharmacologic/non-surgical) obesity interventions are required. Previous research suggests that physical activity and exercise (PA/exercise) might have considerable merit for weight reduction via impacts on mood and other psychosocial correlates of controlled eating. Although as few as 3 bouts/week of low-moderate intensity PA/exercise are associated with improved mood-with no dose-response effect beyond that frequency-it is unknown if mood improvements may be leveraged when participants already complete ⩾3 bouts/week by treatment start.

Objectives: The present research addressed gaps in the available PA/exercise-psychosocial change-weight management research.

Design: This study combined group contrasts with mediation analyses.

Methods: Women participating in a community-based cognitive-behavioral obesity treatment emphasizing the increase of PA/exercise and exercise-related self-regulation and self-efficacy (N = 99) were divided for separate analyses into groupings of <3 bouts/week, and ⩾3 bouts/week, of light (e.g., easy walking) and moderate (e.g., fast walking) PA/exercise regularly completed prior to treatment start. The participants were assessed on psychosocial and PA/exercise changes from baseline to month 3.

Results: Reductions in total mood disturbance (TMD), depression, and anxiety scores were overall significant, with no significant difference by exercise-frequency grouping. PA/exercise increases were significantly greater in the <3 bouts/week groupings. Change in self-regulatory skills usage mediated relations between groupings and changes in TMD, depression, and anxiety. In subsequent serial mediation models, significant paths from grouping → self-regulation change → self-efficacy change → TMD and depression changes were found.

Conclusion: Whether or not ⩾3 bouts/week of PA/exercise are completed at intervention start, TMD, depression, and anxiety may be reduced through treatment foci on increasing PA/exercise, self-regulation, and self-efficacy. Findings might be useful for informing scalable obesity treatments.

Objective: This study explored the health priorities and challenges of midlife women (ages 45-70) in British Columbia, Canada, to identify key elements for a comprehensive, dedicated midlife care program.

Design: We conducted a cross-sectional, mixed methods online survey using convenience, non-probability sampling.

Methods: An online survey (N = 980) assessed health priorities and concerns, care sources, and preferences for a dedicated midlife health program.

Results: Staying physically fit was the top priority, followed by weight management, brain health, and mental wellness, with variations noted: Younger women prioritized weight and mental health, while older participants focused on brain and bone health. Respondents relied on family physicians or walk-in clinics for care, but reported unmet needs across services, including access barriers, care quality, and information gaps. Key components for a midlife program identified in this study were as follows: (1) integrated, whole-person care support; (2) preventative care and early detection; (3) mental health as a priority; (4) access that fits women's lives; (5) relational, personalized, and competent care; (6) accessible information and navigation; and (7) community and peer connection.

Conclusions: The findings offer insights for developing a midlife women's health program that responds to varied and evolving health priorities through holistic, accessible, and patient-centered approaches.

Background: Overweight and obesity are rising globally. During perimenopause years, declining estrogen and changes in body composition increase visceral fat and insulin resistance, increasing cardiometabolic risk.

Objective: To estimate trends in overweight and obesity among U.S. women aged 40-64 years, examine variations by age and state, and project prevalence to 2050.

Design: Secondary analysis of publicly available body mass index (BMI) data accessed through the Global Burden of Disease (GBD) Health Data Exchange, using pooled cross-sectional estimates and hierarchical logistic growth modeling.This sub‑study is not part of the official GBD analysis.

Methods: Harmonized data from the GBD Health Data Exchange integrated National Health Interview Survey, National Health and Nutrition Examination Survey (NHANES), and Behavioral Risk Factor Surveillance System microdata (1990-2021) for nonpregnant women aged 40-64 years, with calibration of self-reported BMI to measured NHANES data. BMI categories followed WHO cutoffs. Weighted estimates were age-standardized, and hierarchical logistic models projected state-specific trends to 2050. The pooled sample included 150,842 women, representing about 90 million weighted person-years. All data were de-identified and publicly available; ethics approval and consent were not required.

Results: Combined overweight/obesity prevalence increased from 49.2% (95% uncertainty interval (UI) 45.8-52.2; 17.7 million (95% UI 16.5-18.8 million)) in 1990 to 74.2% (95% UI 68.8-79.1; 33.4 million (95% UI 31.0-35.6 million)) in 2021, and projected to reach 83.4% (95% UI 75.5-88.3; 41.7 million (95% UI 37.8-44.2 million)). In 2021, rates ranged from 68.3% in Colorado to 82.8% in Mississippi.

Conclusion: Overweight and obesity among midlife women have increased sharply with a continuing shift from overweight to obesity. Menopause-specific preventive strategies and policies promoting physical activity and healthy diet are critical to slow future increases.

Background: Premenstrual tension (PMT) syndrome is a combination of a disruptive set of physical and emotional symptoms that women experience cyclically before the start of each menstrual period. It may impede day-to-day activities and can vary in severity.

Objectives: This study aims to investigate the factors associated with PMT and explore their influences, along with family support, on the academic performance of female university students in Bangladesh.

Design: This study used a cross-sectional design.

Methods: This study is based on primary data collected from 765 female students of Jahangirnagar University, Bangladesh. A well-structured questionnaire, having sociodemographic information, PMT rating scale, and APGAR family function scale. Descriptive statistics, the chi-square test, Monte Carlo approximation test, multivariable logistic regression, and structural equation modeling (SEM) were employed for data analysis.

Results: The findings revealed that 115 (15.03%) respondents demonstrated significant PMT symptoms, of which 54% reported that PMT had an impact on their academic performance, and 67% reported experiencing physical issues. This study also found that family support negatively influences PMT (standardized path coefficient = -0.23). The SEM path analysis indicates that all hypothesized relationships are statistically significant at the 5% level, leading to the rejection of the corresponding null hypotheses. PMT is positively associated with academic performance and is statistically significant (β = 0.505, p < 0.001). Moreover, family support is positively related to academic performance, exhibiting a weak but significant effect (β = 0.083, p = 0.045). Students with PMT were 53% less likely to belong to lower dysfunctional families (adjusted odds ratio (AOR) = 0.47, 95% confidence interval (CI): 0.33-0.66, p < 0.01). Students with chronic illnesses were less likely to belong to lower dysfunctional families (AOR = 0.53, 95% CI: 0.33-0.87).

Conclusion: The findings indicate that strong family support can help alleviate PMT, potentially benefiting students' academic performance. PMT is also associated with family dysfunction and chronic illness. Overall, family care and health awareness play an important role in supporting students' academic success and overall well-being.

Background: Women who experience incarceration lack equitable access and often face barriers to reproductive healthcare, including unmet needs for contraception. Previous studies have demonstrated that women who experience incarceration may want access to contraception and that providing contraception in prisons is feasible; however, it is unclear how this population wants to access contraception, and what their preference is for different forms of contraception.

Objectives: We aimed to explore whether and how people with the capacity for pregnancy would like to access contraceptive education and services while incarcerated in provincial correctional facilities in Ontario.

Design: We used a qualitative descriptive methodology using a qualitative content analysis approach.

Methods: We conducted five focus groups with people aged 18-49 with the capacity for pregnancy and with current or prior experience of incarceration at an Ontario provincial correctional facility. Four groups were held at a provincial correctional facility for women, and one was held over Zoom for community-based participants.

Results: Participants expressed a desire for contraception education and access during the incarceration period, including at intake, discharge, and throughout incarceration. They identified interests in accessible information about contraception, including through pamphlets, posters, and programs, and for care to be provided by a qualified women's health clinician, who preferably was not employed by the jail. Participants felt that there were several barriers to accessing contraception while incarcerated, including long wait times, health care provider and other correctional staff attitudes, and lack of information on contraception options.

Conclusion: This study identifies concrete strategies to address unmet needs for contraceptive care for women in custody. Study findings could inform the development of programs to support equitable contraceptive care access and reproductive health.