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

Objectives: Women with exercise-associated amenorrhea demonstrate cardiovascular perturbations such as endothelial dysfunction and altered lipid profiles. The objective of this systematic review was to assess the effectiveness of pharmacological/nutraceutical and non-pharmacological interventions for improving these cardiovascular perturbations.

Design data sources and eligibility criteria: A literature search was performed in October 2023 and updated in July 2024 of CINAHL (EBSCOhost), Cochrane Library, Embase (Ovid), MEDLINE (Ovid), SPORTDiscus (EBSCOhost), and Scopus from inception to present with no date or language limitations and four sources of gray literature. Experimental and quasi-experimental pre-post studies of women with exercise-associated amenorrhea, using pharmacological/nutraceutical or non-pharmacological intervention, were included.

Results and summary: Three studies from three countries were included. Interventions included 9 months of low-dose oral contraceptives and 4 weeks of folic acid (10 mg/day). Both interventions improved endothelial function in women experiencing exercise-associated amenorrhea, from 1.42% to 4.88% and 3.0% to 7.7%, respectively. The impact of oral contraceptives on lipids was conflicting, and increases were seen in select inflammatory markers, including high-sensitivity C-reactive protein and tumor necrosis factor.

Conclusion: Oral contraceptives or folic acid may improve the endothelial dysfunction associated with exercise-associated amenorrhea. As cardiovascular disease remains a global cause of mortality for women, further investigation into the long-term cardiovascular consequences of impaired vascular and lipid profiles of exercise-associated amenorrhea is warranted.

Introduction: The recent Food and Drug Administration approval of a cervical self-collection method for human papillomavirus detection offers a promising opportunity to improve access to cervical cancer screenings. This study evaluates patients' perceptions of self-collection methods and identifies factors influencing their acceptance.

Methods: MiOra health educators conducted a pilot, cross-sectional, convenience sampling study in Los Angeles County, California, using an Institutional Review Board-approved Qualtrics electronic survey targeting low socioeconomic women. Participants evaluated the perceived ease or difficulty of at-home self-collection methods for vaginal and nasopharyngeal swabs. Associations between sociodemographic, behavioral, and contextual factors with self-sampling preferences were analyzed using chi-square test. Statistical significance was set at 5%, and data were analyzed in R version 4.4.1.

Results: A total of 213 women aged 18 years and older participated in the study, with no exclusions. The majority of participants were under 51 years old (83.6%), Hispanic/Latino (61.5%), and first-generation immigrants (54.5%) in the United States. Women with a middle school or less education were significantly more likely to report perceived difficulty with vaginal self-collection as compared with women with a graduate or professional school education (85.7% vs. 21.4%, respectively, p = 0.009).

Conclusion: Timely cervical cancer diagnosis is crucial for improving treatment outcomes. Findings from this pilot study suggest that formal education may influence women's comfort level with vaginal self-collection. Further research is needed to understand the role of formal education to close the gaps in timely cancer detection.

Objective: To develop a noninvasive clinical diagnostic model based on clinical markers for obstructive sleep apnea (OSA) and to verify its predictive efficacy.

Methods: A retrospective analysis was conducted on female patients who underwent diagnostic sleep monitoring and had complete medical records from January 2021 to April 2023 at Zhongshan Hospital affiliated with Fudan University. The risk factors were analyzed using LASSO regression and multivariate Logistic regression to construct a nomogram predictive model and evaluate its performance. Finally, the predictive efficacy of the constructed model was compared with that of the STOP-Bang score.

Result: A total of 317 female patients were enrolled. Logistic regression analysis revealed that age (OR = 1.045, 95% CI: 1.02-1.072, p < 0.001), snoring (OR = 8.698, 95% CI: 3.439-24.89, p < 0.001), cerebrovascular disease (OR = 28.15, 95% CI: 2.408-931.7, p = 0.025), and Epworth Sleepiness Scale score (OR = 1.217, 95% CI: 1.112-1.348, p < 0.001) were independent risk factors for OSA in females, while insomnia (OR = 0.125, 95% CI: 0.03-0.423, p = 0.002) served as a protective factor. A nomogram predictive model was constructed using the aforementioned independent predictors, exhibiting good discrimination with a C-index of 0.881 (95% CI: 0.84-0.93) in the training cohort and 0.815 (95% CI: 0.73-0.90) in the validation cohort. Comparing the model's area under the curve with that of the STOP-Bang score, the model's predictive efficacy was found to be superior to the STOP-Bang score.

Conclusions: The nomogram predictive model demonstrates good accuracy, consistency, and clinical utility. It aids doctors in the early identification of high-risk female patients with OSA in clinical practice, enabling timely preventive and interventional measures.

Introduction: Returning to physical activity (PA) postpartum is challenging due to physical, psychological, and socio-cultural barriers. Successful return is associated with physical and mental health benefits. Advancements in digital technology access and a digital focus for providers offer potential areas to improve PA; however, current strategies and their efficacy have not been described in the literature.

Methods and analysis: A systematic review of studies evaluating digital technologies in returning postpartum women to PA was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases: Web of Science, SCOPUS, Embase, APA Psycnet, and PubMed were searched from inception until 24 July 2022. Primary objectives were to return to PA postpartum when utilizing digital technologies, and secondary objectives included patient satisfaction and confidence towards returning to PA.

Results: The review returned 14 eligible studies (n = 2714), using digital technologies such as pedometers, text messaging, and smartphone applications. Outcome measures were patient questionnaires, although some used activity trackers. Statistically significant differences in PA were seen in 7 studies with an average intervention increase of approximately 108%. Secondary outcomes of perceived reduction in barriers, increased satisfaction, and self-reported confidence towards engaging in PA were investigated in 6 of the studies, with 4 of the studies reporting an increase in these outcomes.

Conclusion: Digital interventions may play a role in supporting return to PA after childbirth, particularly as part of a multi-modal strategy. However, further research randomizing participants into digital and standard arms is needed to quantify the specific contribution of digital tools.

Background: The purpose of this study was to determine whether gender affects associations between serum urate and cardiometabolic risk factors in age-matched men and women.

Methods: The subjects were 4612 men and 4612 age-matched women (35-60 years old) who had undergone health-checkup examinations. The relationships between high urate (defined as the highest quartile for serum urate) and cardiovascular risk factors were compared between men and women using logistic regression analysis and receiver operating characteristic analysis.

Results: The odds ratio (OR) of subjects with high urate versus subjects without high urate for metabolic syndrome was significantly higher in women than in men (women: 3.82 [95% confidence interval: 2.93-4.97] vs. men: 1.99 [1.63-2.42], p < 0.01), and the ORs for each of the cardiometabolic risk factors (high body mass index [BMI], hypertension, hypertriglyceridemia, low HDL cholesterolemia, and diabetes mellitus) were also significantly higher in women than in men. The ORs of the interaction term consisting of gender (women vs. men) and high urate for each of the cardiometabolic risk factors (high BMI, hypertriglyceridemia, low HDL cholesterolemia, and diabetes mellitus) and metabolic syndrome were significantly higher than the reference level. In receiver operating characteristic analysis, area under the curve of the relationship between serum urate and each of high BMI, hypertension, hypertriglyceridemia, low HDL cholesterolemia, high LDL cholesterolemia, diabetes, and metabolic syndrome was significantly larger in women than in men. The cutoffs of serum urate for metabolic syndrome were 6.25 and 4.65 mg/dL in men and women, respectively, which are lower than those currently used.

Conclusions: The associations between hyperuricemia and cardiometabolic risk factors were age-independently stronger in women than in men. The results suggested that the cutoff values for hyperuricemia that are currently used should be redefined from the viewpoint of prevention of cardiovascular disease.

Background: Schizophrenia poses a significant health challenge for women of reproductive age globally. This study aimed to analyze the global burden of schizophrenia among this population from 1990 to 2021 and project trends to 2040.

Methods: We utilized data from the Global Burden of Disease Study 2021 to examine the incidence, prevalence, and disability-adjusted life years (DALYs) of schizophrenia among women aged 15-49 years. We analyzed trends across Sociodemographic Index (SDI) regions, performed decomposition analysis, assessed health inequalities, and projected future burdens.

Results: From 1990 to 2021, global incidence cases increased by 35.68% to 513,255, while age-standardized incidence rates slightly decreased by 1.00%. Prevalence cases rose by 55.82% to 7,541,989. Low SDI regions experienced the highest percentage increases in burden. Decomposition analysis revealed population growth as the primary driver of increased burden globally (85.4% for DALYs), with varying patterns across SDI regions. Health inequality analysis showed a growing concentration of prevalence and DALYs in higher SDI regions. Projections indicate continued global increases in absolute burden through 2040, with decreasing age-standardized rates.

Conclusions: The burden of schizophrenia among women of reproductive age has increased substantially, driven primarily by population growth, with significant disparities across SDI regions. Tailored interventions addressing region-specific drivers are needed to mitigate the growing impact of schizophrenia on this population.

Objective: To investigate the effects of half-day outpatient management of gestational diabetes mellitus (GDM) on blood glucose, fetal weight, maternal, and infant outcomes during the COVID-19 epidemic.

Materials and methods: From January 1, 2020, to December 31, 2022, 4674 pregnant women were diagnosed with GDM in the Woman and Child Care Center of Qinhuangdao City. Patients with GDM were divided into the case group and the control group according to their own wishes. To retrospectively analyze the differences in the maternal and infant outcomes between the two groups, the glucose tolerance, blood glucose levels before meals, 2 hours after meals, and at bedtime before delivery, hemoglobin A1C before delivery, mode of delivery, birth weight, and maternal and infant complications, perinatal complications of the two groups were observed.

Results: There were significant differences in fasting blood glucose, blood glucose levels at 1 hour and 2 hours after sugar intake between the two groups at the time of admission. Before meals, 2 hours after meals, and at bedtime before delivery, blood glucose levels, and hemoglobin A1C were lower than those of the control group, and the difference was significant. There was no significant difference between the two groups in the complications of low-weight infants, neonatal asphyxia, stillbirth, polyamniotic fluid, premature rupture of membranes, hypertensive diseases during pregnancy, and postpartum hemorrhage. Significant differences were observed in complications such as macrosomia, neonatal hypoglycemia, and neonatal hyperbilirubinemia.

Conclusions: The half-day outpatient management of GDM can effectively control the blood glucose level of pregnant women with GDM and improve clinical outcomes.

Purpose: Accurate knowledge of the fertile window-the period within the ovulatory cycle when conception is most likely-is important to reproductive health and informed family planning. Prior research has consistently documented low to moderate awareness of this concept, particularly among young adults. This study examined sociodemographic and reproductive variables associated with fertile window knowledge among individuals of reproductive age in Colombia and Ecuador.

Methods: Data were drawn from a cross-sectional analysis within the ongoing international "FERTIPLAN" project, which investigates fertility intentions in Latin America. The sample comprises 1456 participants (73.4% women, 26.6% men) aged 18-44 years from Colombia and Ecuador.

Results: Women were nearly twice as likely as men to demonstrate knowledge of the fertile window (odds ratio [OR] = 1.98; 95% confidence interval [CI]: 1.32-2.97). All age groups aged 25 years and older exhibited significantly higher odds of fertile window knowledge compared with the 18-24 age group (ORs ranging from 1.89 to 2.45), but no significant differences were observed among the older age groups, indicating that the primary knowledge gap lies between the youngest cohort and all older age groups. Participants with higher income (OR = 2.59; 95% CI: 1.54-4.35), fertility intentions (OR = 1.47; 95% CI: 1.06-2.04), and familiarity with fertility awareness-based methods (OR = 2.55; 95% CI: 1.58-4.12) had significantly greater knowledge of the fertile window.

Conclusions: These findings underscore the influence of sex, age cohort, socioeconomic status, and reproductive factors on fertility awareness, offering valuable insights for advancing preconception care and addressing knowledge gaps in Latin America.

Introduction: It is projected that the global population of adults above age 60 years will surpass 2 billion by 2050. Age-related cognitive decline represents a prevalent issue and research has demonstrated that women are at greater risk than men. Changes in cognitive function with age are influenced by many factors and may include lifetime exposure to estrogen and the transition to menopause. While the exact relationship between estrogen and the aging brain is unclear, the hormonal changes in menopause have been associated with a decline in gray matter volume. However, some studies have demonstrated that the use of hormone therapy may mitigate some of the effects of cognitive decline.

Methods: The current study used magnetic resonance imaging and voxel-based morphometry to examine the relationship between gray matter volume and endogenous lifetime estrogen exposure (e.g., reproductive period length or age of menopause - age of menarche in years) and differences in gray matter volume between women who used hormone therapy (N = 62, M_age = 70.97 [2.97], M_edu = 12.43 [3.22]) and those who did not (N = 62, M_age = 70.14 [2.62], M_edu = 12.81 [3.75]). It was hypothesized that higher lifetime estrogen exposure and use of hormone therapy would be correlated to greater gray matter volume. The data were retrieved from the Women's Healthy Ageing Project.

Results: Results demonstrated no significant correlations between whole brain gray matter volume and lifetime estrogen exposure. There were no significant differences between groups based on hormone therapy use. However, there was a nonsignificant relationship that suggested that women who did not use hormone therapy had greater gray matter volume than those who did use it.

Discussion: As the aging population continues to grow globally, it is essential to better understand the variables that influence trajectories of aging; especially for women, who are particularly at risk for age-related cognitive decline.