The Utah women's health review最新文献

Background: While plausible mechanisms exist for an association between endometriosis and hypertriglyceridemia, prior studies have shown inconsistent findings, possibly due to the inability to assess endometriosis severity or subtypes.

Objectives: Among 473 premenopausal individuals undergoing gynecologic laparoscopy, the present study assessed the association between incident endometriosis and non-fasting serum triglycerides.

Methods: Participants were recruited (2007-2009) among women undergoing diagnostic or therapeutic laparoscopy or laparotomy (for any indication) and who had no prior endometriosis diagnosis. Endometriosis was categorized using American Society for Reproductive Medicine staging (I-IV). Typology was defined as superficial endometriosis [SE], ovarian endometrioma [OE], and deep infiltrating endometriosis [DE]. We collected biospecimens, anthropometrics, and self-reported sociodemographics at enrollment, prior to surgery. We evaluated the association between endometriosis diagnosis, stage, typology, and triglyceride concentrations using non-fasting female cutpoints (normal <175mg/dL vs hypertriglyceridemia ≥175mg/dL) via generalized linear models. We also evaluated whether the association differed by menstrual cycle phase.

Results: Among the cohort, 108 women (23%) had hypertriglyceridemia > 175 mg/dL. Overall, endometriosis was not associated with prevalence of hypertriglyceridemia (adjusted prevalence ratio (aPR): 1.24, 95% CI: 0.87, 1.77), after accounting for baseline age, race/ethnicity, marital status, BMI, income, and serum cotinine. However, this varied by stage and type. Women with moderate to severe stage endometriosis had a higher aPR for hypertriglyceridemia, 1.74 (95% CI: 1.03, 2.95), compared to those without endometriosis. DE combined with OE was associated with a 3.59 higher aPR (95% CI: 2.33, 5.54) for hypertriglyceridemia. A pattern emerged showing stronger associations in the follicular phase compared to the luteal phase.

Conclusions: In summary, while no association was observed for overall endometriosis and hypertriglyceridemia, we observed moderate to severe stage endometriosis as well as DE and OE endometriosis was associated with prevalence of hypertriglyceridemia.

Objectives: The objective of this study is to test the association between preconception polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) using Utah's Pregnancy Risk Assessment Monitoring System (2016-2021). In addition, pre-pregnancy hypertension will be tested as a potential effect moderator.

Methods: This cross-sectional study utilizes data from Phase 8 of the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2016-2021). The association between PCOS and GDM was tested using Poisson regression to generate adjusted prevalence ratios and 95% confidence intervals.

Results: PCOS was associated with higher prevalence of GDM in all models, regardless of whether the outcome data (GDM) came from the infant's birth certificate, the PRAMS survey, or the combined measure. When adjusting for sociodemographic characteristics, lifestyle factors, reproductive history, and comorbidities, women with PCOS were 1.50 (1.16-1.95) times as likely to have GDM (reported on birth certificate and/or survey) compared to women without PCOS. Pre-pregnancy hypertension was not found to be a statistically significant effect moderator.

Conclusions: The findings from this study were consistent with the majority of research indicating that women with PCOS have increased risk for GDM. This is also the first known study to test pre-pregnancy hypertension as an effect moderator between PCOS and GDM. More research is needed on the role of comorbidities such as chronic hypertension as effect modifiers between PCOS and GDM.

Implications: These findings show that women with PCOS are at high risk for GDM, among a population-based sample of mothers. Interventions to reduce the risk of GDM among women with PCOS need to be developed and evaluated.

Objectives: Women play an important role in promoting healthy eating and physical activity within their households, influencing the current and life-long health behaviors of children. The purpose of this study is to describe changes in fruit/vegetable consumption and physical activity among children living with racially and ethnically diverse women participating in a lifestyle-change intervention.

Methods: The study involves secondary analysis of data from a randomized trial of a wellness-coaching intervention led by Community Health Workers, called Community Wellness Coaches in this study. Study participants came from five diverse racial/ethnic communities. Participants received monthly vs. quarterly wellness coaching. Data on changes in the health behaviors of children at four months after enrollment were collected through interviews. Children's behavior changes were compared by study arm, demographics, and women's health behaviors.

Results: Overall, 71.9% of women reported increases in the fruit/vegetable intake of children living in their household and 59.4% reported increases in children's physical activity. There were no differences in children's fruit/vegetable intake or physical activity by study arm (p=0.88). Women who reported that their own fruit/vegetable intake increased were more likely to report an increase in children's consumption (aOR=2.55, 95%CI 1.05 - 6.21).

Conclusion and implications: Among women of color participating in a health-behavior change intervention, women's behavior changes were associated with improvements in child health behaviors. Interventions focused on improving women's health behaviors may also impact the behaviors of children and other household members. Emphasizing the role of women on the health of children in such interventions may magnify this impact.

Introduction: Breastfeeding has immediate and long-term benefits for both maternal and child health. This study examines the association between Baby-Friendly Hospital Initiative (BFHI) experiences and breastfeeding outcomes in the Mountain West region.

Methods: A cross-sectional (retrospective secondary data analysis) was performed using the 2016 Pregnancy Risk Assessment Monitoring System (PRAMS) data. The participants were derived from a stratified random sample of 2,013 women living in Utah and Wyoming who recently had a live birth and who were surveyed on BFHI practices. The association between BFHI experiences and breastfeeding duration were assessed using crude and adjusted Poisson regression models, controlling for other BHFI experiences and maternal age, pre-pregnancy BMI, household income, smoking, alcohol, delivery method, and number of days spent in the hospital post delivery.

Results: 82.4% and 82.3% of women from Utah and Wyoming, respectively, reported breastfeeding for 2 months or longer. After controlling for other BFHI experiences and potential confounders, the one shared BFHI experience that was associated with breastfeeding for 2 months or longer vs less than 2 months was starting breastfeeding in the hospital (adjusted prevalence ratio [aPR]=1.49, 95% CI (1.12, 1.98) in Utah and aPR=2.03, 95% CI (1.13, 3.64) in Wyoming. Among women in Utah and Wyoming, only 5 of 7 BFHI steps were significant for breastfeeding duration in at least one state.

Conclusion: There is substantial epidemiological support for health benefits to both mother and infant for exclusive breastfeeding to 6 months and prolonged breastfeeding until at least 1-year. Our findings suggest that women who initiate breastfeeding in the hospital may be more likely to breastfeed for a longer duration.

Objective: To investigate the association between pre-pregnancy body mass index (BMI) and subfertility within a population-based cohort, exploring Hispanic ethnicity as a potential effect modifier.

Methods: We used cross-sectional study data from the Utah Pregnancy Risk Assessment Monitoring System from 2012-2015. Relationships between maternal pre-pregnancy BMI and subfertility were evaluated via Poisson regression models with robust error variance, accounting for the stratified survey sampling. Preconception BMI was analyzed continuously and categorically. Women's subfertility was defined via self-report in two ways: 1) time trying to achieve pregnancy; and 2) report of using fertility-related drugs/medical procedures.

Results: The median age was 27.0; 18.8% were obese, and 15.9% were Hispanic. Women with preconception obesity (BMI>30kg/m²), compared to normal weight women (18.4kg/ m²2) had a 1.85 (95% CI 1.43, 2.38) higher adjusted prevalence ratio (aPR) for having subfertility defined by time trying and a 1.73 (95% CI 1.20, 2.32) higher aPR for receiving fertility-enhancing drugs/medical procedures. Continuous models indicated a linear relationship between BMI and subfertility (aPR 1.04, 95% CI 1.03, 1.06 for time trying; and 1.06, 95% CI 1.03, 1.10 for receiving fertility-enhancing drugs/medical procedures).

Conclusions: Obese women, but not underweight or overweight women, reported higher subfertility than normal-weight women. Findings among this cohort of at-risk new mothers, oversampled on low education and birth weight and comprised of higher than the national average of Hispanics, indicated a dose-response relationship between obesity and subfertility.

Implications: Our findings highlight the importance of population-oriented obesity prevention for at-risk women with intentions to conceive.