Women's health (London, England)最新文献

Background: Irisin is a myokine potentially linked to insulin sensitivity. Polycystic ovarian syndrome (PCOS) is a prevalent hormonal condition defined by insulin resistance. Previous studies have reported elevated circulating irisin levels in adult females with PCOS.

Objective: To examine the differences in serum irisin levels between lean and obese adolescents and young adults with PCOS and their respective lean and obese controls and to explore the relationship between irisin levels and the metabolic and reproductive characteristics of the participants.

Design: Cross-sectional study design.

Methods: The study included 60 cases of PCOS and 60 controls. These participants were categorized based on their body mass index (BMI) into lean and obese. Fasting serum irisin levels, physical, metabolic, hormonal, and reproductive characteristics of the participants were measured.

Results: Lean cases of PCOS had significantly elevated levels of fasting serum irisin (PCOS = 17.07 ± 5.61 ng/ml vs lean controls = 11.04 ± 7.51 ng/ml; p = 0.002), glucose, insulin, homeostasis model of assessment-insulin resistance index (HOMA-IR), luteinizing hormone (LH), estradiol, and testosterone and significantly lower levels of quantitative insulin sensitivity check index (QUICKI) compared to the lean controls. Obese cases of PCOS had significantly higher levels of fasting serum irisin (PCOS = 22.06 ± 3.83 ng/ml vs obese controls = 16.86 ± 6.74 ng/ml; p = 0.011), glucose, insulin, HOMA-IR, LH, estradiol, and testosterone and significantly lower levels of follicle-stimulating hormone (FSH) and QUICKI compared to obese controls. The findings revealed a significant positive correlation of serum irisin levels with BMI, glucose, insulin, HOMA-IR, LH, estradiol, and testosterone(all p-values < 0.001). There was also a significant positive correlation with triglycerides (TAGs) (p = 0.001), total cholesterol (p = 0.005), and low-density lipoprotein cholesterol (p = 0.024). Additionally, there was a significant negative correlation with high-density lipoprotein cholesterol (p = 0.001) and QUICKI (p < 0.001) in the entire study cohort. Fasting serum glucose (β = 0.337, p = 0.029), TAGs (β = 0.249, p = 0.006), and LH (β = 0.382, p = 0.004) were positive predictors of serum irisin concentrations in the overall sample.

Conclusion: Lean and obese adolescent and young adult cases of PCOS had significantly higher fasting serum irisin levels than their respective controls. Metabolic and reproductive traits of the participants also correlated with irisin.

Background: Abortion-related complications are the third leading cause of maternal mortality in Uganda, accounting for approximately one-fourth of all maternal deaths. Most are preventable through adequate use of the full package of postabortion care (PAC) services.

Objective: We aimed to assess the level of utilization of PAC services and the associated sociodemographic, obstetric, gynecological, and system-related factors at a high-volume tertiary health facility in Northern Uganda.

Design: A cross-sectional survey was conducted among women receiving PAC at the Gulu Regional Referral Hospital from March 2023 to June 2023. Participants were recruited consecutively and exit interviews were conducted using structured questionnaires.

Methods: Utilization of PAC was defined as the use of four or more of the following: counseling, emergency treatment, family planning services, linkage to other sexual and reproductive health services, and community health service provider cooperation. Modified Poisson regression analysis was used to determine the independent predictors of PAC utilization.

Results: A total of 364 participants were enrolled in the study. Overall, 21.1% (n = 77) of the participants had used four or more PAC services. Having a supportive partner (adjusted prevalence ratio (aPR): 1.9, 95% confidence interval (CI): 1.19-2.88, p = 0.006), knowledge on PAC services (aPR: 1.7, 95% CI: 1.19-2.48, p = 0.004), low parity (aPR: 2.2, 95% CI: 1.16-4.35, p = 0.016), nulliparity (aPR: 2.4 95% CI: 1.19-4.73, p = 0.014), and provision of privacy(physical privacy during prescription, counseling, procedures) (aPR: 2.3 95% CI: 1.14-4.47, p = 0.02), were significantly associated with utilization of PAC.Overall, only one in five participants utilized four or more PAC services. Use of four or more PAC services was significantly associated with women having a supportive partner, knowledge of PAC services, low parity, nulliparity, and provision of privacy while receiving PAC services.

Conclusion: Approaches such as advocating male partner involvement, bridging the knowledge gap through health education, and promoting respectful care may improve the utilization of PAC services.

Background: Black women are disproportionately impacted by higher rates of maternal mortality in the United States (US). Limited research has focused on adverse maternal health outcomes among college-educated Black women, although research has found these outcomes persistent among this population.

Objectives: This study aimed to fill a critical gap in current research by elucidating the nuanced experiences of college-educated Black women in the workplace during pregnancy and postpartum. By exploring this under-researched area, our study contributes to the academic discourse on Black maternal health disparities within the scope of occupational health. It offers practical insights for enhancing workplace gender equity, informing healthcare practices, and shaping policies that support equitable maternal health outcomes among Black women.

Design: This qualitative study conducted semi-structured interviews with 17 Black mothers between March 2019 and September 2019.

Methods: Seventeen in-depth interviews were conducted with college-educated Black women in the US from March 2019 to September 2019. Participants were asked several questions about work stress, discrimination, and other workplace experiences during pregnancy and postpartum.

Results: Our analysis identified three themes, including Strong Black Woman/Superwoman, work stress (sub-themes: consciousness of work stress, mental and physical responses to stress, and work-family conflict), and perceived work-related discrimination.

Conclusion: For college-educated Black women experiencing pregnancy and postpartum, it is crucial to understand the structural and social determinants of optimal occupational health. It is critical that workplaces enact occupational health equity with attention to racial, gender, and disability-centered considerations to address the unique challenges experienced by Black women.

Background: Black women are too often overlooked and underserved by the mental health system, resulting in disparities in their access to care and services provided. Little attention has been given to understanding the mental health experiences of Black women or to the development of culturally responsive, effective interventions that promote equitable access and services for these women.

Objectives: This study provides an opportunity to understand the lived experiences of young Black women with mental health challenges and their engagement with mental health services.

Design: A descriptive phenomenological approach was used to understand the lived experiences of young Black women with mental health challenges and their engagement with mental health services.

Methods: Using a descriptive phenomenological approach, loosely structured interviews with 15 Black women, ages 18-30 years, experiencing mental health challenges were conducted.

Results: A thematic analysis revealed five overarching themes: (1) the "Strong Black Woman" persona as a barrier to seeking care, (2) impact of mental health stigma in the Black community, (3) intergenerational mental health trauma among Black women, (4) lack of culturally responsive practitioners, and (5) the impact of COVID-19 on mental health.

Conclusion: The findings suggest practitioners need to consider the intersecting identities of Black women when developing culturally responsive interventions. Additionally, concepts such as identity shifting, identity centrality, and radical healing should be considered when addressing the unique experiences of young Black women.

Background: Although challenges in breastfeeding are more common in mothers of preterm infants, maternal breastfeeding self-efficacy is a modifiable factor that may improve breastfeeding rates.

Objective: To evaluate the factors affecting breastfeeding self-efficacy among mothers with preterm babies.

Design: A cross-sectional study.

Methods: This study was carried out using a double-stage cluster sampling method. In total, 360 mothers of preterm infants under 6 months of age were included. Data were collected using sociodemographic characteristics, Breastfeeding Self-efficacy Scale-Short Form (BSES-SF), multiple scales of perceived social support, and Depression, Anxiety, and Stress questionnaires.

Results: The results showed social support (15.6%), depression (12.2%), anxiety (11%), and stress (12.2%) contributed independently, and together they explained 25% of the variance in BSES-SF. The higher levels of social support (β = 0.283), lower levels of mental health problems (β = -0.340), having breastfeeding experience (β = -0.253), and higher gestational age at birth (β = 0.106) were significantly related to the high level of BSES-SF.

Conclusion: These findings can help healthcare providers be aware of effective factors in improving breastfeeding self-efficacy. Increased access to counselors, active support for mothers after preterm labor, and increased support facilities for mothers with preterm delivery may be helpful to improve breastfeeding self-efficacy.

Background: Older Black women experience structural and intersectional disadvantages at the intersection of age, race, and gender. Their disadvantaged social statuses can translate into serious psychological health consequences. One concept that may aid in understanding psychosocial determinants of older Black women's depression risk is the "Strong Black Woman," which suggests that Black women have supernatural strength amidst experiencing adversity and are expected to "be strong" for others by providing self-sacrificial aid without complaint.

Objectives: Drawing inspiration from the "Strong Black Woman" concept, the current study examined whether three psychosocial factors (i.e., mastery, anger suppression, and relational demands (from spouse, children, relatives, and friends)) were associated with depressive symptoms, clinically significant depressive symptoms, and lifetime professionally diagnosed depression among older Black women (i.e., ages 50 years and older).

Design: This was a cross-sectional study. Data were drawn from the 2010 to 2012 waves of the Health and Retirement Study (N = 1,217).

Methods: For past-week depressive symptoms, ordinary least squares regression analyses were conducted, and beta coefficients were reported. For clinically significant depressive symptoms (i.e., reporting three or more depressive symptoms in the past week) and lifetime professionally diagnosed depression, binary logistic regression analyses were performed, and odds ratios were reported.

Results: Higher levels of mastery were associated with lower risk for depressive symptoms and depression. Anger suppression was associated with higher risk for depressive symptoms and depression. Demands from children and one's spouse were associated with higher depressive symptoms while demands from family were associated with risk for lifetime depression diagnosis. Not having a spouse was associated with heightened risk of depressive symptoms and depression. Interestingly, demands from friends were not associated with depressive symptoms nor diagnosed depression.

Conclusion: Study findings revealed important nuances in the determinants of depression among older Black women which, in turn, has implications for research and mental health care provision in this population.

Background: Kidney transplantation is a superior treatment for end-stage renal disease (ESRD), compared with hemodialysis, offering better quality of life and birth outcomes in women with ESRD and lower fertility rates.

Objectives: To investigate the pregnancy, maternal, fetal, and graft outcomes following kidney transplantation in women with ESRD and evaluate the improvements in quality of life and associated risks.

Design: A systematic review and meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology guidelines.

Data sources and methods: A thorough search of multiple databases, including PubMed, Embase, Scopus, ATC abstracts, and Cochrane Central Register of Controlled Trials, was conducted to identify studies that analyzed pregnancy outcomes in kidney transplant patients. The search was conducted from the inception of each database to January 2023.

Results: The study reviewed 109 studies that evaluated 7708 pregnancies in 5107 women who had undergone renal transplantation. Of these, 78.48% resulted in live births, 9.68% had induced abortion, and 68.67% had a cesarean section. Miscarriage occurred in 12.54%, preeclampsia in 20.87%, pregnancy-induced hypertension in 24.30%, gestational diabetes in 5.08%, and preterm delivery in 45.30% of cases. Of the 853 recipients, 123 had graft loss after pregnancy and 8.06% suffered acute rejection.

Conclusion: Pregnancy after kidney transplantation is associated with risks for mother and fetus; however, live births are still possible. In addition, there are reduced overall risks of stillbirths, miscarriages, neonatal deaths, and gestational diabetes.

Registration: PROSPERO (CRD42024541659).

There is a lack of standardized measurement tools globally to assess knowledge, attitudes, and perceptions of expecting women toward prenatal screening. The purpose of this systematic review was to identify reasons women pursue or decline prenatal screening and compare the strengths and limitations of available measurement tools used to assess pregnant women's perceptions, knowledge, and attitudes toward prenatal screening. This review followed the five-step York methodology by Arksey and O'Malley and incorporated recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist for the extraction, analysis, and presentation of results. The five steps consisted of: (1) identification of the research questions; (2) searching for relevant studies; (3) selection of studies relevant to the research questions; (4) data charting; and (5) collation, summarization, and reporting of results. Four online databases (PubMed, Embase, Web of Science, and Cochrane Library) were selected after the librarian's development of a detailed search strategy. The Rayyan platform was used between June 2023 and August 2023 to epitomize the articles produced from our search. A total of 68 eligible studies were included in the analysis. The top five major reasons for declining prenatal screening uptake included (1) being unsure of the risk of prenatal screening and harm to the baby or miscarriage (n = 15), (2) not considering action such as termination of pregnancy for prenatal screening to be considered as necessary (n = 14), (3) high cost (n = 12), (4) lack of knowledge about testing procedures and being anxious about the test (n = 10), and (5) being worried about probability of false negative or false positive results (n = 6). Only 32 studies utilized scientifically validated instruments. Difficulties in capturing representative, adequately sized samples inclusive of diverse ethnicities and demographics were pervasive. Findings highlight the need for rigorous validation of research measurement methodologies to ensure the accuracy and applicability of resulting data regarding the assessment of prenatal screening perceptions, knowledge, and attitudes across diverse female populations.Registration: N/A.

Background: Persistent pelvic pain is pain sensed in or around the pelvis and is often associated with negative cognitive, behavioral, sexual, and emotional consequences. The lack of interprofessional persistent pelvic pain management programs that address the complex interplay of biopsychosocial factors result in lengthy wait times and negative health outcomes. Limited access to evidence informed self-management educational resources contributes to poor coping strategies. Evidence shows that self-management education and strategies support patients while they wait for care. However, very few studies explore the patient's lived experience of participating in an online educational program designed for persistent pelvic pain.

Objectives: This study aims to understand the experience of women with persistent pelvic pain participating in an online, self-management education program ("Pelvic Pain Empowered Management" program) while awaiting care at an interprofessional pelvic pain clinic.

Design: A descriptive qualitative approach was used to explore the experiences of women participating in an online educational program designed for cis women with persistent pelvic pain.

Methods: We conducted semi-structured interviews with 11 women, transcribed the data verbatim using NVivo software (NVivo 12, QSR International Pty Ltd.), and analyzed inductively using previously established methods.

Results: We identified four main themes relevant to women's experiences of the program: (1) the program shaped expectations around upcoming pelvic pain appointments, (2) the program content is relevant and resonates with people with lived experience of persistent pelvic pain, (3) the program enhanced understanding of persistent pelvic pain, and (4) the program empowered people with skills and strategies to better manage their persistent pelvic pain.

Conclusion: Our findings highlight how self-directed online patient education can be leveraged while persistent pelvic pain patients wait for care to support them in setting expectations around care and in engaging in pain self-management.