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

Background: Exposure to stressors impacts maternal and infant health. Growing evidence suggests stressful life events (SLEs) are associated with adverse infant birth outcomes. The objective of this study was to determine how SLEs affected infant outcomes (low birth weight [<2500 g], preterm birth, and small for gestational age), and how these effects were influenced by race/ethnicity and hypertensive disorders of pregnancy.

Methods: The weighted prevalence of SLEs and adverse infant outcomes were investigated using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2020. Adjusted risk ratios were estimated for the effects of SLEs, hypertensive disorders of pregnancy (including hypertension before pregnancy and pregnancy-induced hypertension), and race/ethnicity on infant outcomes using multivariable log-binomial modeling.

Results: The dataset included 452,031 women between the ages of 18 and 45. During the year before giving birth, the incidence of self-reported SLEs was between 66% and 72%. Black mothers had more SLEs, significantly increased risk of preterm birth (<37 weeks) and low birth weight.

Conclusion: Adverse infant outcomes were more likely among Black mothers participating in PRAMS, perhaps because of a higher number of self-reported SLEs.

Aim: To explore sensor-derived glycemic metrics during pregnancy in women with type 1 diabetes using insulin degludec or other basal insulin analogs.

Methods: A post hoc analysis of 87 pregnant women with type 1 diabetes using intermittently scanned continuous glucose monitoring and multiple daily injections, including basal insulin analogs in the CopenFast trial. Glycemic metrics, including mean sensor glucose, time in range (TIRp, 3.5-7.8 mmol/L), and time below range in pregnancy (TBRp, <3.5 mmol/L), were assessed from periconception to 37 completed weeks.

Results: In total, 58 women used degludec and 29 women used other basal insulin analogs. At baseline (median = 9.5 gestational weeks, interquartile range = 9.0-11.0), hemoglobin A1c was 50 ± 9 versus 46 ± 6 (p = 0.04) mmol/mol, and diabetes duration was 16 (10-21) versus 9 (4-19) years (p = 0.35). The use of faster-acting insulin aspart and insulin aspart was equally distributed in the two groups. Glycemic metrics were comparable throughout pregnancy for 24 hours in both groups. During nighttime, mean sensor glucose was higher and TIRp was lower in women using degludec compared with women using other basal insulin analogs, while TBRp was above treatment targets in both groups throughout pregnancy. Severe hypoglycemia occurred in 1 (2%) versus 5 (17%) (p = 0.01). Birthweight standard deviation score was 1.5 ± 1.2 versus 0.8 ± 1.1 (p = 0.01).

Conclusions: In this post hoc analysis, pregnant women with type 1 diabetes using degludec achieved lower nighttime TIRp, experienced less severe hypoglycemia, and delivered infants who were heavier and thereby had less appropriate size compared with women using other basal insulin analogs.

Background: Endometrioid endometrial carcinoma (EEC) is the most prevalent malignancy affecting the female reproductive system, and obesity is a significant risk factor. In this study, we examined the influence of saturated fatty acids (SFAs) on early-stage EEC progression.

Methods: A two-sample Mendelian randomization (MR) analysis using single-nucleotide polymorphisms as instrumental variables was used to assess the potential causal associations among body mass index (BMI), the main components of adipose tissue, and EEC. Clinical data from 231 patients with EEC at Benxi Central Hospital were analyzed according to BMI categories. CCK-8, apoptosis, cell cycle, scratch, and transwell assays were used to examine the biological behavior of Ishikawa cells treated with palmitic acid (PA), the main SFA component. GraphPad Prism v10.2.0 was employed to perform correlation analysis.

Results: MR analysis revealed a statistically causal relationship between BMI and EEC (inverse variance weighted, p = 3.573 × 10^-7). Furthermore, SFAs (inverse variance weighted, p = 0.032) and triglycerides (inverse variance weighted, p = 0.036) played a notable role in the influence of BMI, and a high BMI was correlated with cervical invasion risk (p < 0.001). PA promoted Ishikawa cell proliferation at 24 hours and significantly enhanced migration and invasion at 48 hours.

Conclusions: This research highlights the clinical significance and implications of BMI in the evaluation of poor prognosis in early-stage EEC and the potential role of SFAs in the proliferative, migratory, and invasive abilities of EEC. Our findings emphasize the importance of dietary weight management, particularly for patients with stage I EEC.

Objective: To explore symptoms, knowledge levels, perceptions, and use related to menopause and hormone therapy (HT) and to examine the factors associated with HT use and HT perceptions in perimenopausal and postmenopausal women.

Materials and methods: We used a sample of 98 perimenopausal and postmenopausal women who aged 50-79 and participated in the Sex, ApoE-4, γ-aminobutyric acid, and Episodic memory (SAGE) study (M _age = 64.24, standard deviation = 7.49). We applied a series of bivariate Firth logistic regressions to examine the associations of each variable of interest with hormone therapy (HT) use and perceptions.

Results: Overall, 89.90% reported positive perceptions of menopause, and 85.71% had positive perceptions of HT. One-third (32.65%) of the sample had used HT. Hot flashes (72.4%) were the most reported menopausal symptom. Logistic regression analyses showed that age, race/ethnicity, current drinking status, menopausal knowledge levels, and vasomotor and genitourinary symptoms were significantly associated with HT use, while race/ethnicity, current drinking status, menopausal knowledge levels, and genitourinary symptoms were also linked to positive HT perceptions. Hispanic participants reported lower menopausal knowledge, less positive HT perceptions, and lower HT use.

Conclusions: The majority of women in the SAGE cohort reported positive perceptions of both menopause and HT. Race/ethnicity, along with current drinking status, menopausal knowledge levels, and genitourinary symptoms, were consistently associated with both HT use and HT perceptions. Ethnic differences in menopausal knowledge levels, HT perceptions, and HT use are also discussed.

Background: Women who use drugs (WWUD) experience increasingly worse outcomes from drug use as compared to men. Additionally, transactional sex, unstable housing, and unmet needs may further complicate their ability to get needed health care. To inform the design of gender-based, mobile health services, we sought perspectives on health care service delivery from WWUD and health care and harm reduction professionals (HHRPs) in Seattle, WA.

Materials and methods: In 2023, we conducted qualitative interviews with WWUD (n = 16) and HHRPs (n = 5) in the Seattle, Washington area. Interviews focused on experiences receiving health care services, barriers and facilitators to accessing care, and preferences for health care service delivery. Interviews were audio recorded, transcribed, and double coded. Final learnings were reviewed with the study's community advisory boards.

Results: All WWUD participants identified as cisgender women, 12 (75%) identified as White, and 11 (69%) had unstable housing. Analysis identified four themes that characterized perspectives of WWUD and HHRP on health care service delivery needs, embodied by: safety, stigma, hope, and resiliency. Participants described that lack of safety and unmet basic needs made it challenging for WWUD to ever feel healthy (theme 1), and that WWUD felt stigmatized by mainstream health care services in intersectional ways (theme 2). However, participants shared that these burdens were lessened when health care teams created space for hope in care delivery interactions (theme 3) and built resiliency by reducing barriers and complementing care with structural supports (theme 4).

Discussion: In this small qualitative sample, WWUD experienced a myriad of intersecting challenges that perpetuated marginalization and health disparities. This population may benefit from interventions rooted in intersectional and trauma-informed approaches.

Background: Mailed human papillomavirus (HPV) self-sampling kits improve cervical cancer screening adherence. The HOME trial found information needs and anxiety among HPV-positive patients. We designed a STEP trial to test optimized intervention strategies with bolstered educational materials and a centralized nurse communicating positive results. Here, we evaluate the effect of the strategies by comparing interviews of HOME and STEP participants receiving HPV-positive results.

Materials and methods: STEP participants were interviewed during December 2021-March 2022, and asked about their kit reaction and nurse communication, and surveyed on attitudes toward the kit. Transcripts were analyzed in two phases: (1) Coders used iterative content analysis to organize codes into node reports and identify themes and (2) coders compared node reports between the HOME and STEP trials.

Results: Sociodemographic of 46 HOME and 28 STEP participants were similar (White, older, had prior Pap). Participants from both trials appreciated the kit's convenience, although some questioned its accuracy compared to clinician-performed screening. While many STEP participants were surprised by the positive result, most felt reassured by the nurse and understood the recommended follow-up. STEP participants expressed fewer negative emotions. More STEP than HOME participants believed the HPV result was correct (86% vs. 59%) and trusted it (90% vs. 65%). Willingness to recommend the HPV kit to a friend and use it in the future was high in both the trials.

Discussion: Qualitative comparison of HOME and STEP participants' reactions suggests STEP patients received the information needed to understand HPV-positive results and complete follow-up. Findings support a centralized nurse communicating results and building trust in this new screening technology.

Objective: To determine the association between stress, as objectively measured by frequency of neighborhood gunshots and preterm birth (PTB).

Study design: A retrospective chart review of 1675 individual births was analyzed of pregnant women who lived in the City of Syracuse, New York, United States. The frequency of gunshots was measured in the acute phase (within 1 week of delivery) and the chronic phase (sum total of all gunshots in the previous 2 years). Primary outcome includes PTB prior to 37 weeks of gestation. Secondary analysis includes delivery prior to 34, 32, and 28 weeks of gestation.

Result: Gunshots were significantly different between the three districts of Syracuse, which matched with differences in socioeconomic and comorbid conditions. The different districts also experienced differences in frequency of PTB (highest 18%, medium 13%, lowest 12%, p = 0.018). However, those with versus without PTB at any gestational age did not differ in the frequency of gunshots in acute phase or chronic phase.

Conclusion: The use of acute-phase and chronic-phase gunshots as a method to simulate stress levels is not associated with the development of PTB.

Background: More than one third of academics are coupled with another academic, with more women being in such dual-career relationships. Little is known about how these couples' experiences affect their attrition from or persistence in academia.

Methods: We analyzed survey data of academics at 100 U.S. colleges and universities to answer two research questions: (1) Among all academic partners, who are the most likely to abandon their desired academic careers in terms of their gender, race, and field? (2) What effects does leaving academia have on those partners' career outcomes?

Results: We found that 22% of aspiring academics in academic relationships leave that career pathway. One third leave for personal reasons, including to prioritize their partner's career. When partners leave academia for personal reasons, they are less likely to be employed in any job and, when employed, are paid less than their counterparts who leave academia for professional reasons. Among our results, we found notable gender differences. Compared with men, women in medicine were more likely to leave academia for personal reasons. Moreover, the earnings of women who leave academia due to personal reasons are the most negatively impacted.

Conclusions: These trends indicate that the choices made by dual-career couples in response to the academic job market and to universities' policies for partner hiring have substantial effects on the demographic makeup of academic research and scholarship. By supporting the needs of academic couples, universities have the opportunity to make their own institutions more diverse and to patch a hole in the leaky pipeline.

Introduction: Vasomotor symptoms (VMS) are the most commonly reported menopausal symptoms and vary across race and ethnicity, with higher prevalence and duration among Black and Hispanic women. This study describes demographics/clinical characteristics and treatment patterns of peri/menopausal and postmenopausal women with symptomatic menopause/VMS and asymptomatic menopause in a commercial claims population.

Methods: Data from Optum's deidentified Clinformatics Data Mart Database were obtained for peri/menopausal (aged 40-54 years) and postmenopausal (aged 55-64 years) women. VMS is not available directly in claims data and was proxied using symptomatic menopausal ICD-9/10 codes. In Phase 1, prevalence of symptomatic and asymptomatic peri/menopause (defined by ICD-9/10 codes) and baseline demographics/clinical characteristics were obtained. Phase 2 included baseline demographics/clinical characteristics, symptomatic menopause/VMS incidence rates, and treatment patterns.

Results: Phase 1 included 1,987,355 ICD-9/10 codes for symptomatic or asymptomatic menopause. Peri/menopausal women had lower symptomatic menopause/VMS prevalence compared to postmenopausal women (6.5% vs. 4.9%). Symptomatic menopause/VMS prevalence was 5.7% and highest in White (6.3%) and lowest in Asian (3.4%) women.Phase 2 included 203,546 (53.3%) peri/menopausal and 178,658 (46.7%) postmenopausal women. Symptomatic menopause/VMS incidence was 1.2%; only 52.9% were treated. Lower incidence and treatment rates were seen among Asian (0.46%; 33.2%), Hispanic (0.43%; 46.7%), and Black (0.41%; 47.1%) women compared to White (0.59%; 55.5%) women.

Conclusions: This study adds to the literature by characterizing women with symptomatic menopause/VMS across the menopausal spectrum and shows that caution is needed when interpreting real-world claims data due to inherent claims database limitations. As there are no specific ICD codes for VMS, difficulties exist in utilization of claims data to accurately capture VMS characteristics and treatment patterns.

Background: Somaliland, despite a global trend toward lower fertility rates, exhibits a high total fertility rate of 5.7 per woman. This study aimed to investigate the prevalence and associated determinants of fertility decisions among married reproductive-age women in Somaliland.

Methodology: A cross-sectional study using data from the 2020 Somaliland Health and Demographic Survey was conducted. A multinomial logistic regression analysis was employed to explore the association between individual-level (age, education, occupation, contraceptive use) and community-level (residence, region) factors and fertility decisions.

Results: The study found that 54.4% of married reproductive-age women in Somaliland desire more children within the next 2 years, indicating a strong preference for larger families. Younger women, those residing in rural areas, and those with lower education levels were more likely to desire more children. Exposure to mass media was associated with a lower desire for more children, while contraceptive use intentions also significantly influenced fertility decisions.

Conclusion: This study provides valuable insights into the complex interplay of socioeconomic, cultural, and individual factors shaping fertility decisions in Somaliland. The findings highlight the need for targeted interventions, including education, access to family planning services, and mass media campaigns, to empower women to make informed choices about family size.