Women's health reports (New Rochelle, N.Y.)最新文献

Background: Adverse childhood experiences (ACEs) are traumatic events that occur during childhood. Previous evidence suggests that pregnancy loss may be associated with ACEs and mental health disorders; however, to our knowledge, no studies have considered these associations in women with concurrent reproductive trauma (CRT), defined as pregnancy loss during infertility.

Purpose: To compare ACEs, stress, anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms among women with CRT and women with infertility only.

Methods: A descriptive cross-sectional study design was used to recruit 99 U.S. women with infertility through convenience and snowball sampling on Facebook, Instagram, and at fertility clinics. A REDCap survey included demographics, ACEs questionnaire, infertility-related stress (COMPI-FPSS), perceived stress (PSS-4), anxiety (GAD-7), depression (PHQ-8), and PTSD (PC-PTSD-5). Statistical analysis using SPSS 28 included descriptive statistics, independent t-tests, and chi-square test for independence.

Results: Women with CRT were more likely to experience 2+ ACEs than women with infertility-only (p = 0.001), with four ACEs occurring more often. Infertility-only group with 2+ ACEs had significantly higher levels of stress, PTSD, anxiety, and depression, with clinically significant higher depression and PTSD symptoms. CRT group with 2+ ACEs had significantly higher anxiety and depression, with clinically significant higher moderate or severe depression.

Discussion: Although women with CRT and infertility experienced similar levels of psychological distress, having an ACE history worsened their mental health symptoms. ACE history may be associated with reproductive traumas, though further studies are needed. Trauma-informed care should be implemented for women with ACEs, infertility, and CRT.

Background: Prior studies have documented fertility concerns among adolescents and young adult women, but reasons for these perceptions have not been fully elucidated. We explored the origins and dimensions of fertility concerns in a sample of U.S. young adults assigned female sex at birth.

Methods: We conducted focus groups with participants aged 18-25 years recruited from reproductive health centers in Minnesota, United States, from 2021 to 2022. Eligible participants were assigned female sex at birth, had recent penile-vaginal sex, had never been pregnant, were not attempting pregnancy, and self-identified as having ever been worried about their fertility. Transcripts were analyzed qualitatively for themes regarding: (1) reasons for fertility concerns and (2) participants' perceptions of their current fertility.

Results: Participants (n = 19) were predominantly cisgender and 47% were Black, Hispanic, or Multiracial. Reasons for fertility concerns emerged under three domains: personal history of unprotected sex without subsequent pregnancy, risk factors (e.g., contraceptive use, environmental exposures), and psychosocial factors such as inflated perceptions of infertility prevalence. Participants who thought they would have difficulty conceiving in their current state cited mostly evidence-based risk factors like irregular menses and comorbidities; participants who thought it would be relatively easy referenced a lack of those same factors.

Conclusions: Young people with fertility concerns cite myriad reasons and do not necessarily believe they are currently infertile. Sexual and reproductive health messaging for adolescents and young adults should broaden beyond pregnancy prevention to proactively dispel misconceptions and alleviate fears related to fertility and infertility.

Objective: Utilizing the 2021 Global Burden of Disease (GBD) data, this study assessed the global epidemiological landscape of polycystic ovary syndrome (PCOS), offering an empirical foundation for PCOS-related health service planning.

Methods: Data from the GBD 2021 database were extracted to examine the global distribution and trends of PCOS. The metrics included total case counts, prevalence, disability-adjusted life years, age-standardized prevalence rate (ASPR), and estimated annual percentage change (EAPC). Analyses incorporated age-period-cohort modeling and frontier efficiency assessments.

Results: Between 1990 and 2021, the global ASPR of PCOS exhibited a marked upward trajectory. Significant regional heterogeneity was observed; Southeast, East, and South Asia registered the steepest ASPR growth, whereas tropical Latin America and high-income Asia Pacific displayed relatively stable trends. At the national level, countries such as Equatorial Guinea, Maldives, and Myanmar recorded ASPR increases exceeding 100%, in contrast to reductions seen in high-income nations including Italy. Age-specific patterns revealed that women aged 20-44 years consistently bore the highest burden. The age-period-cohort analysis indicated heightened risk in more recent birth cohorts from low- and middle-socioeconomic development index (SDI) regions, coupled with persistent health disparities despite some narrowing in socioeconomic gaps, as reflected by a decline in concentration indices from 0.24 to 0.1. The frontier analysis identified high-SDI countries, including the United States and Japan, as performing suboptimally in mitigating the PCOS burden relative to their resource capacity.

Conclusion: The global burden of PCOS has intensified over the past three decades, with a disproportionate impact in low- and middle-SDI regions. The syndrome predominantly affects women of reproductive age, especially those between 20 and 39 years of age. Although socioeconomic inequalities have lessened to some extent, disparities remain significant, and resource-rich nations continue to underperform in addressing the disease burden. Comprehensive strategies emphasizing timely diagnosis, equitable health care access, and lifestyle interventions are imperative to address this escalating global health concern.

Introduction: Thousands of Hispanic parturients give birth in the United States annually, necessitating accessible health education resources in Spanish. Given the known Hispanic maternal care disparities and high reading levels of Spanish-written patient education materials (PEMs), this study aims to assess the readability and quality of obstetric (OB) anesthesia Spanish-language PEMs from a general internet search and academic leaders. We hypothesize that the readability and quality of PEMs from academic leaders will be superior to those found via general internet search.

Methods: To identify Spanish-written PEMs on OB anesthesia, the webpages of 62 academic medical centers (AMCs) recognized as OB anesthesia leaders were screened. A general internet search using "anestesia y alivio del dolor durante el parto" ("anesthesia and pain relief during labor and delivery") was conducted to find an equal number of additional resources. Readability was assessed using the Fernandez-Huerta Readability Index (FHRI) and Indice de Legibilidad de Flesch-Szigriszt (INFLESZ) analyses, while quality was evaluated using the DISCERN instrument and the Health Education Materials Assessment Tool (HEMAT).

Results: Twenty-eight Spanish-language PEMs from AMCs and 28 from a general internet search were identified. The FHRI and INFLESZ readability analyses revealed that PEMs from both cohorts primarily aligned with a 9-10th grade reading level. These reading levels significantly exceeded the recommended 4-6th grade level (p < 0.001). DISCERN scores indicated no quality difference between cohorts. Both groups achieved high HEMAT scores for understandability.

Conclusion: The readability of online OB anesthesia Spanish-written PEMs from AMCs and a general internet search was both similar and higher than recommended. Quality did not differ between both cohorts. Improvements in readability and quality are needed for better patient-centered care and to emphasize the importance of shared decision-making.

Introduction: Maternal distress is a significant risk factor for adverse pregnancy and birth outcomes across generations. Psychotherapy can reduce distress and build resilience, potentially mitigating the effects of inter- and transgenerational stress.

Methods: This study examined whether an integrated, personalized psychotherapy approach focused on inter- and transgenerational stress can be associated with improved pregnancy and birth outcomes. Records from 239 women and their babies were collected between 2004 and 2012 at a private clinic specializing in gynecology, obstetrics, psychosomatics, and psychotherapy in Germany. Pregnant women received routine gynecological care alongside complementary psychotherapeutic interventions, including system-oriented psychosomatic therapy, solution-focused therapy, salutogenesis, and couple therapy, with emphasis on inter- and transgenerational stress. These data were compared with birth records from regional standard care deliveries in the city of Pforzheim (n = 18,690) and the state of Baden-Württemberg (n = 815,832).

Results: The findings showed that complementary psychotherapy was associated with lower rates of primary and secondary cesarean sections, fewer vaginal surgical procedures, a higher proportion of spontaneous births, and a lower preterm birth rate compared with standard care. Women receiving psychotherapy had an 18.2% higher likelihood of spontaneous birth and a lower observed preterm birth rate (2.2%) than those in standard care (9.0%). Infants of mothers in the psychotherapy group were heavier, taller, and had larger head circumferences.

Conclusion: In this study, psychotherapeutic counseling within standard gynecological care was linked to longer pregnancy duration, improved birth mode, and greater birth weight. These findings suggest psychotherapy can be a safe, preventive approach during pregnancy to support maternal well-being and promote healthier outcomes for newborns.

Background: Although the prevalence of secondary traumatic stress (STS) in Obstetrics and Gynecology (OBGYN) is established, little is known about its effect on different OBGYN providers. We examined variances in impact of STS between OBGYN faculty, house officers (HO), and certified nurse midwives (CNM), as well as barriers and desired resources for support.

Methods: All OBGYN providers at one academic institution received a survey in May 2024 assessing prevalence of STS, distress, resources, and barriers to support. Differences among provider types were examined by likelihood-ratio Chi-squared tests.

Results: Of 165 individuals receiving the survey, 92 (55.8%) responded (faculty 57.0%, HOs 57.8%, CNMs 50.0%). Most respondents (91.3%) had experienced a traumatic work event; faculty reported the highest rate (95.9%). While all respondents experienced high rates of psychological and physical distress from an adverse event, faculty were most fearful of future occurrences (90.9% vs. HOs 69.6%, CNMs 53.9%, p = 0.03) and reported more difficulty sleeping (36.4% vs. HOs 17.4%, CNMs 23.1%, p = 0.04). Adverse events negatively impacted professional self-efficacy. Faculty, particularly, reported high rates (76%) of feeling inadequate, although this was not statistically different from HOs (55%) or CNMs (50%), p = 0.31. All groups cited involvement in a legal situation as the principal reason for seeking support, peer support as the preferred intervention, and time as the biggest barrier to seeking support.

Conclusions: Nearly all OBGYN providers experience STS after adverse events. This study highlights stressors unique to faculty. Intentional programming and support for faculty are needed to promote well-being and professional development.

Background: This study aims to estimate the general prevalence of violence against women and its associated factors, including co-occurrence in the municipality of Vitória, Espírito Santo.

Methods: This population-based cross-sectional study was carried out in the municipality of Vitória, Espírito Santo, Brazil, with 1086 women who were interviewed in their homes. Data were analyzed in Stata 15.1. The chi-squared test of heterogeneity was used for the bivariate analysis. Poisson's regression with robust variance estimation was used to calculate crude and adjusted prevalence ratios and their respective 95% confidence intervals.

Results: Overall violence throughout life represented a total of 47.8%, 13.0% of which co-occurred with psychological, physical, and sexual violence. Eleven percent of the participants reported psychological and physical violence episodes. Women between 40 and 49 years old had a 31% higher prevalence of intimate partner violence in their lifetime than older women. Catholics had a 33% lower prevalence of violence than non-Catholics. Those who lived without a partner endured a 1.4 times greater occurrence of violence. Women with up to 8 years of schooling and belonging to the second socioeconomic tertile had higher frequencies of violence. Regarding family experiences of violence, women whose mothers had been attacked by their partners had a 32% higher prevalence of overall violence in their lives (p < 0.05).

Conclusions: This study associated victims' polyvictimization and some of their main behavioral and family characteristics that can increase their chances of suffering violence. It is also important that future national and international studies evaluate the co-occurrence of violence experienced by women.

Introduction: Caregiving responsibilities in academic science, technology, engineering, mathematics, and medicine disproportionately impact early-career faculty, particularly women, exacerbating stress, mental health challenges, and career progression barriers. The Doris Duke Charitable Foundation (DDCF) launched the Fund to Retain Clinical Scientists to support clinician-scientists facing these challenges, expanding efforts during the COVID-19 pandemic. The Icahn School of Medicine at Mount Sinai leveraged DDCF funding in 2021 to expand its Distinguished Scholar Award (DSA) program, first launched in 2020.

Methods: To enhance faculty support, we convened an interdisciplinary team with expertise in faculty development, integrating tailored programming through collaborative working sessions. In 2022, seven scholars were funded; in 2023, five were awarded. The cohorts represented diverse gender identities, racial and ethnic backgrounds, and research disciplines.

Results: Summative evaluations revealed that 83% of respondents found quarterly check-ins with program directors most useful, followed by "Meet the Expert" sessions (67%). Findings highlight the value of structured mentorship and institutional support in fostering research continuity and gender equity.

Discussion: Over 2 years, the DSA program provided both financial and professional development support, addressing key challenges faced by junior faculty with caregiving responsibilities. While scholars benefited from mentorship and career development opportunities, participation in additional resources varied, raising questions about how best to balance program structure with flexibility. The ongoing challenge remains on how to equitably support caregivers in science and medicine without adding undue burdens. Our experience underscores the importance of continued dialogue and strategic program refinement to ensure lasting impact.

Objective: This study explores the effectiveness of tibolone and combined hormone therapy (HT) in alleviating sleep disorders in women aged 40-65 who are in menopausal transition and postmenopause.

Methods: The ambidirectional cohort study (retrospective 2011-2015; prospective 2016-2021), conducted at Shanghai Sixth People's Hospital's specialized menopause clinic. Participants were given tibolone or combined HT based on their STRAW + 10 stratification and preference for continued menstruation. Demographic information, baseline, and reevaluated performance of the Pittsburgh Sleep Quality Index (PSQI) were collected for analysis of their differentiations and impact factors. Sleep quality was reassessed 12 months after treatment initiation via PSQI.

Results: The cohort study involved 285 participants-184 in the tibolone cohort and 101 in the combination HT cohort. After 12 months, PSQI scores improved by -3.76 ± 4.12 with tibolone and -3.66 ± 4.23 with combined HT. The adjusted between group difference was -0.359 (95% confidence interval = 0.577; p = 0.534).

Conclusions: The study suggests that tibolone and combined HT improved sleep to a similar extent after adjustment. Further comprehensive research is necessary to corroborate these observations.

Objective: To determine the presence or absence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in second-trimester amniotic fluid during the SARS-CoV-2 virus pandemic in patients undergoing genetic amniocentesis.

Study design: Women undergoing amniocentesis between September 2020 and April 2022 were asked to participate in the study. On the day of amniocentesis, an additional 5 mL of amniotic fluid, 5 mL of maternal blood sample, and nasal swabs were collected from each participant. None of the patients had active SARS-CoV-2 infection on the date of amniocentesis. Demographic data and history of SARS-CoV-2 virus infection were collected. After 2021, the SARS-CoV-2 virus vaccination status was obtained. Amniotic fluid and maternal nasal swabs were collected and tested for the presence of the SARS-CoV-2 virus via real-time reverse-transcriptase polymerase chain reaction test using an automated bead-based method for extracting total nucleic acid. An electrochemiluminescence immunoassay on maternal blood was used to detect SARS-CoV-2 total (immunoglobin G/immunoglobin M) antibodies against nucleocapsids.

Results: This study enrolled 92 patients. There were 16 patients who reported a history of SARS-CoV-2 virus infection: 8 of them reported SARS-CoV-2 virus infection during the first and second trimesters and 8 reported SARS-CoV-2 virus infection before pregnancy. A total of 49 patients were vaccinated prior to amniocentesis. All 92 amniotic fluid samples tested negative for the SARS-CoV-2 virus. There were five positive and three negative SARS-CoV-2 maternal nucleocapsid antibody tests among the eight patients who had the SARS-COV-2 viral infection during the first and second trimesters of pregnancy. All eight patients had negative swab tests for the SARS-CoV-2 virus.

Conclusions: There was no SARS-CoV-2 virus in the second-trimester amniotic fluid samples from the eight patients who reported SARS-CoV-2 viral infection during the first and second trimesters. This finding suggests that, after a first- and second-trimester SARS-CoV-2 virus infection, it is unlikely to find the SARS-CoV-2 virus in the amniotic fluid.