BMC Women's Health最新文献

Objective: To evaluate the Swede score for the prediction of high-grade cervical lesions in women undergoing colposcopy without cytology results. This simulates the upcoming scenario in Brazil of HPV-based screening for women testing positive for HPV 16/18.

Methods: This was a partial analysis of an ongoing cross-sectional study that prospectively included 86 women referred for colposcopy due to cytological abnormalities to a public referral center in Rio de Janeiro, Brazil, between September 2023 and June 2025. All women went to colposcopy evaluation. Colposcopy was performed by an examiner blinded to the referral cytology. For this analysis, we included all women with a fully visible squamocolumnar junction (transformation zone types 1 or 2). The gold standard was the histopathological repor. In cases where no biopsy or excisional treatment was performed, classification relied on final colposcopic impression and cytology. Diagnostic performance (sensitivity, specificity, predictive values, and likelihood ratios) was calculated using different Swede score cutoffs. Post-test probabilities were calculated assuming a 20% pre-test probability of CIN2+.

Results: Prevalence of CIN2 + was 33.7%. Swede score ≥ 8 predicted CIN2 + with a positive predictive value (PPV) of 100% and a likelihood ratio of 55.17. Post-test probability in a HPV 16/18-positive scenario without cytology in this threshold was estimated at 93%.

Conclusion: The Swede score cutoff ≥ 8 in women who tested positive for HPV 16/18 and had fully visible transformation zones can be an accurate method to predict that they have CIN2+. These results could support the decision to proceed with immediate treatment without prior cytology or biopsy.

Trial registration: Not applicable. This study does not report the results of a health care intervention.

Little research exists surrounding vulnerable birthing people and their relationships with planning and preventing pregnancy. This study aims to better describe services and barriers that impact family planning choices, including housing, primary care provider accessibility, and insurance access among participants in the Parent Child Assistance Program (PCAP). Participant data was derived from 59 participants enrolled in PCAP, a case management program for birthing people who use substances. Amongst the participants who were recently pregnant, 7/59 (12%) were using birth control around the time of conception of that pregnancy. Of the participants who were not recently pregnant, 53% of clients were using birth control upon intake. This figure rises incrementally by 24 months. Data showed that those with health insurance are almost twice as likely to be using contraceptives at intake. The low prevalence of birth control use even after a recent pregnancy suggests significant barriers still exist in terms of education and access to family planning resources for birthing people. This indicates the need for targeted interventions and supports that empower birthing people to make decisions about their reproductive health.

Background: Perimenopause presents considerable physical and psychological challenges. Adopting a healthy lifestyle is crucial for navigating this transition. While social support and psychological resilience are known to be related to health behaviours, their interrelationships among perimenopausal women remain unclear.

Methods: This cross-sectional study enrolled 366 perimenopausal women from a health management centre in Southwest China between February and June 2023 using a convenience sampling method. Data were collected via a structured questionnaire comprising several sections: the demographic characteristics questionnaire, the Chinese version of the Health-Promoting Lifestyle Profile, the Social Support Rating Scale, and the Chinese version of the Connor-Davidson Resilience Scale. Following data entry in Excel 2016, statistical analyses, including descriptive statistics, correlation analysis, and multivariate regression, were conducted using SPSS 26.0. Structural equation modelling was performed with AMOS 24.0 to test the hypothesized pathways among variables. The significance level was set at α = 0.05, and model fit was evaluated using established goodness-of-fit indices.

Results: The mean health-promoting lifestyle profile score was 98.01 (SD = 18.60). Multiple linear regression revealed several significant factors: menopausal status (β = 3.228, P = 0.033), the presence of chronic diseases (β = -4.761, P = 0.012), having regular medical examinations (β = 6.275, P < 0.001), social support (β = 0.358, P < 0.001), and psychological resilience (β = 0.567, P < 0.001). The SEM results further suggested that the association between social support and a healthy lifestyle was consistent with an intermediary role for psychological resilience. The indirect association was significant (95% bootstrap CI: 0.495-0.929), accounting for 61.32% of the total association.

Conclusion: Social support is directly associated with healthier lifestyles among perimenopausal women, and psychological resilience appears to play an important intermediary role. Strengthening both social support and psychological resilience may help promote better health behaviours in this population. Health care professionals should consider integrating these elements into tailored perimenopausal health programs.