International Journal of Women's Health最新文献

{"title":"Willingness of Chinese Breast Cancer Patients for Their Children to Undergo <i>BRCA1/2</i> Genetic Testing and Associated Factors.","authors":"Xue Yu, Min Wu, Lei Liu, Chun Zhang","doi":"10.2147/IJWH.S595354","DOIUrl":"https://doi.org/10.2147/IJWH.S595354","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic variants in <i>BRCA1/2</i> are important risk factors for breast cancer. However, little is known about whether Chinese breast cancer patients are willing for their children to undergo genetic testing. This study assessed patients' knowledge and attitudes toward genetic testing and risk management, and identified factors associated with willingness for their children to undergo <i>BRCA1/2</i> testing.</p><p><strong>Methods: </strong>A questionnaire-based survey was conducted among 608 newly diagnosed breast cancer patients at Peking University International Hospital between May 2020 and May 2025. Participants were asked whether they would be willing for their children to undergo <i>BRCA1/2</i> genetic testing. Factors associated with reported willingness were analyzed using multivariable logistic regression.</p><p><strong>Results: </strong>The mean age was 51.8 ± 12.3 years (range, 22-87 years). Most participants were married (96.9%) and had children (89.8%). Overall, 57.6% correctly recognized that breast cancer can be hereditary, while 37.2% were uncertain and 5.3% believed it was not hereditary. Only 61.7% knew that men can also develop breast cancer, and 42.2% did not correctly understand the relationship between pathogenic variants and breast cancer risk. Although 51.8% had heard of Angelina Jolie's preventive mastectomy, only 23.2% had received genetic risk counseling from healthcare professionals. Overall, 67.4% reported willingness for their children to undergo <i>BRCA1/2</i> testing. Older age (OR=0.976, 95% CI: 0.960-0.992; <i>P</i>=0.003) and having only sons (OR=0.310, 95% CI: 0.142-0.677; <i>P</i>=0.003) were independently associated with lower reported willingness, whereas awareness of the Angelina Jolie effect was associated with greater reported willingness (OR=2.036, 95% CI: 1.360-3.048; <i>P</i>=0.001).</p><p><strong>Conclusion: </strong>Chinese breast cancer patients showed limited awareness of hereditary breast cancer risk. Several demographic and sociocultural factors were associated with reported willingness for children to undergo <i>BRCA1/2</i> testing. These findings may help inform family-centered genetic counseling and hereditary cancer education in China.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"595354"},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Dietary Patterns Among Women Undergoing Assisted Reproduction and Its Association with Reproductive Outcomes.","authors":"Rongyan Zhang, Shengnan Cong, Jing Zhao, Yuxuan Wu, Yueyue Cai, Linhong Li","doi":"10.2147/IJWH.S603264","DOIUrl":"https://doi.org/10.2147/IJWH.S603264","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify dietary patterns among women undergoing assisted reproductive technology (ART) and to analyze the association between these patterns and reproductive outcomes.</p><p><strong>Methods: </strong>This study included 331 women who underwent assisted reproductive technology at a tertiary hospital in Jiangsu Province between June and December 2024. Dietary intake was assessed using a semi-quantitative food frequency questionnaire, and nutrient values were calculated with a nutrition calculator. Reproductive outcomes were obtained from medical records. Then, we used principal component analysis to identify dietary patterns, and we performed non-parametric tests and multivariate regression analyses to explore associations between dietary patterns, nutrient intake, and reproductive outcomes.</p><p><strong>Results: </strong>Three dietary patterns were identified: the Diversified Diet Pattern, the Snack-Beverage-Staple Pattern, and the Staple-Vegetable Pattern. No significant association was found between dietary patterns and reproductive outcomes (p > 0.05). Regarding individual nutrients, higher vitamin B2 intake was linked to more high-scoring blastocysts (p = 0.003). Higher cholesterol intake was associated with fewer retrieved oocytes (p = 0.008) and morphologically normal oocytes (p = 0.029). Higher zinc intake was associated with fewer morphologically normal oocytes (p = 0.012), number of mature oocytes (MII oocytes) (p = 0.039), and high-quality embryos (p = 0.036). No significant associations were found between other nutrients and reproductive outcomes (all p > 0.05).</p><p><strong>Conclusion: </strong>Although different dietary patterns were not associated with reproductive outcomes, the intake of specific nutrients, such as cholesterol, vitamin B2, and zinc, may influence reproductive outcomes. Further research is needed to explore the underlying mechanisms and to develop targeted interventions for women undergoing ART.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"603264"},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Fetal Ventriculomegaly: A Retrospective Analysis from a Tertiary Referral Center.","authors":"Danhua Guo, Shuqiong He, Na Lin, Yifang Dai, Ying Li, Liangpu Xu, Xiaoqing Wu","doi":"10.2147/IJWH.S576118","DOIUrl":"https://doi.org/10.2147/IJWH.S576118","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate perinatal outcomes in fetal ventriculomegaly (VM).</p><p><strong>Methods: </strong>We retrospectively reviewed 720 pregnancies diagnosed with fetal ventriculomegaly (VM) between 2014 and 2018. Cases were classified as isolated ventriculomegaly (IVM, n = 451) or non-isolated ventriculomegaly (NIVM, n = 269) based on the presence of additional prenatal imaging abnormalities. According to the width of the lateral ventricles, VM was further categorized as mild (10-11.9 mm, n = 555), moderate (12-14.9 mm, n = 88), or severe (≥15 mm, n = 77). Serial prenatal ultrasound measurements were used to evaluate intrauterine progression, which was defined as regressive (≥2 mm decrease), stable (<2 mm change), or progressive (≥2 mm increase) ventricular width. Periodic antenatal and postnatal imaging data were collected, and pregnancy outcomes were obtained through medical records and telephone follow-up.</p><p><strong>Results: </strong>Overall, favorable outcomes were observed in 93.75% of IVM cases, with rates of 95.31% in mild, 89.2% in moderate, and 25.0% in severe VM. In IVM cases, severe VM (OR = 60.214), intrauterine stability (OR = 5.687), and progression (OR = 34.88), were significantly associated with adverse outcomes. The NIVM group showed a significantly higher rate of pregnancy termination compared with the IVM group (39.5% vs 8.9%, p < 0.05). Among ongoing pregnancies, adverse outcomes were also more frequent in the NIVM group than in the IVM group (15.6% vs 6.25%, p < 0.05). Among cases with adverse outcomes, persistent intracranial imaging abnormalities were identified in 66.7% of NIVM cases and 57.1% of IVM cases.</p><p><strong>Conclusion: </strong>NIVM correlates with high termination/adverse outcome rates. VM severity intrauterine stability and progression are key risk factors, necessitating continuous imaging surveillance for optimal management.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"576118"},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality and Access to Postnatal Care Among Women in Somalia: Evidence from the 2020 Somalia Demographic and Health Survey.","authors":"Ifrah Muktar Hussein, Abdifetah Ibrahim Omar, Yahye Sheikh Abdulle Hassan, Shafie Abdulkadir Hassan, Abubakar Yakubu Abbani","doi":"10.2147/IJWH.S577425","DOIUrl":"https://doi.org/10.2147/IJWH.S577425","url":null,"abstract":"<p><strong>Background: </strong>Neonatal mortality remains high in Somalia, and inadequate postnatal care (PNC) contributes substantially to preventable maternal and newborn deaths. Although PNC is critical during the first days after childbirth, both access to services and the content of care remain limited. This study examined access to postnatal care and the determinants of receiving appropriate-quality PNC among Somali women.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the 2020 Somalia Demographic and Health Survey. The analysis included 2813 women aged 15-49 years who had a live birth within the five years preceding the survey. Access to PNC was defined as receiving any postnatal check after delivery. Among women who received PNC, appropriate-quality care was defined as receiving all six essential postnatal care components within 48 hours of delivery. Weighted descriptive statistics and multivariable Poisson regression were used to identify factors associated with receiving appropriate-quality PNC.</p><p><strong>Results: </strong>Most women had no formal education and delivered at home. Access to postnatal care was limited, and among women who received PNC, only 3% obtained appropriate-quality care. Coverage of individual postnatal components was consistently low. Husband's education and adequate antenatal care attendance were strongly associated with higher likelihood of receiving appropriate-quality PNC, while substantial regional disparities were observed.</p><p><strong>Conclusion: </strong>Both access to and quality of postnatal care in Somalia are extremely limited. Expanding skilled maternal services, strengthening antenatal care utilization, and improving community-based postnatal outreach are essential to improve maternal and newborn outcomes.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"577425"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short Birth Intervals, Maternal Care, and Neonatal Mortality in Rwanda: A Facility-Based Retrospective Cohort Study Using Hierarchical Modelling.","authors":"Nadine Niyomahoro, Mojeed Akorede Gbadamosi","doi":"10.2147/IJWH.S590844","DOIUrl":"https://doi.org/10.2147/IJWH.S590844","url":null,"abstract":"<p><strong>Background: </strong>Neonatal mortality remains a major public health concern in sub-Saharan Africa. Evidence from facility-based studies may be affected by selection and referral biases. This study examined the association between short birth intervals, maternal care, and other maternal, reproductive, and healthcare factors at different causal levels and neonatal mortality in a referral hospital in Rwanda, using a hierarchical modelling approach.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 1042 mother-neonate pairs admitted between 2022 and 2023. Variables were grouped into distal (socioeconomic), intermediate (reproductive), and proximal (clinical) levels. Sequential logistic regression models were applied. Due to substantial non-random missingness in birth interval data, complete-case analysis was used for intermediate model, with sensitivity analyses to assess robustness. A Directed Acyclic Graph was used to evaluate potential biases.</p><p><strong>Results: </strong>Among 1,042 neonates, 32 (3.07%) died. Lower maternal education was associated with higher odds of neonatal mortality (aOR 2.18; 95% CI 1.08-4.54), although this may reflect selection bias. Short birth interval showed an inverse association with neonatal mortality, but this finding was unstable and not interpretable due to non-random missing data and bias. Proximal factors showed consistent associations: inadequate antenatal care (<4 visits) was associated with higher odds (aOR 3.12; 95% CI 1.29-7.54), and preterm birth was strongly associated (aOR 11.67; 95% CI 3.74-36.35).</p><p><strong>Conclusion: </strong>Proximal clinical factors, particularly preterm birth and inadequate antenatal care, were consistently associated with neonatal mortality. Associations with distal and intermediate factors were affected by bias and missing data, limiting their interpretability. These findings underscore the need for caution when interpreting hospital-based data and highlight the value of hierarchical modelling with causal frameworks.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"590844"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction Model for Overall Survival in Patients with Epithelial Ovarian Cancer Undergoing Surgery and Systemic Therapy Based on the 2010-2021 SEER Database.","authors":"Hongtang Shi, Shaowei Zhan, Yujiao An, Miaolong He, Zhen Xu","doi":"10.2147/IJWH.S588058","DOIUrl":"https://doi.org/10.2147/IJWH.S588058","url":null,"abstract":"<p><strong>Purpose: </strong>Epithelial ovarian cancer (EOC) is a common gynecological malignancy, and accurate survival prediction after treatment remains challenging. Our aim was to construct a nomogram that effectively evaluates the overall survival (OS) of patients with EOC after surgery and systemic therapy.</p><p><strong>Patients and methods: </strong>Patients with EOC who underwent surgery and systemic therapy and were enrolled in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2021 were divided into training and test sets in a 7:3 ratio for internal validation. Univariate Cox regression analysis, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analysis were used to screen independent risk factors and construct a nomogram to predict OS. Model discrimination was assessed using the time-dependent area under the receiver operating characteristic curve (AUC). Calibration curves were plotted to evaluate agreement between predicted and observed survival, and clinical utility was assessed using decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 17,285 EOC patients who underwent surgery and systemic therapy were included, with a median follow-up of 69 months. During follow-up, 4799 patients had died and 7282 remained alive. The final model included thirteen variables: age, race, marital status, histological classification, tumor size, CA125, T/N stage, cancer summary stage, FIGO stage, time from diagnosis to treatment, treatment sequence, and the extent of regional lymph node dissection. The 5-year AUC of the prediction model was 0.77 (95% CI: 0.76-0.78) in the training cohort and 0.77 (95% CI: 0.75-0.79) in the test cohort. The Brier scores ranged from 0.051 to 0.193 in training and test sets. These results indicate that the model possesses acceptable discriminatory capability and stability.</p><p><strong>Conclusion: </strong>We developed a nomogram based on clinical variables to provide individualized estimation of OS in EOC patients who underwent surgery and systemic therapy.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"588058"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-Derived Uterine Sector 2 Placental Area and Cervical Area Are Associated with Massive Hemorrhage in Complete Placenta Previa with Placenta Accreta Spectrum.","authors":"Guannan Feng, Zhiyi Yang, Peiran Yang, Yongfei Yue","doi":"10.2147/IJWH.S582651","DOIUrl":"https://doi.org/10.2147/IJWH.S582651","url":null,"abstract":"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) is an obstetric complication related to severe maternal morbidity and mortality, magnetic resonance imaging (MRI) can predict the bleeding risk and the adverse outcomes of the maternal caesarean section in PAS patients. The aim of the current study was to determine relationship of placenta area in sector 2 (S2) and cervical area measured by MRI with massive hemorrhage (MH) in complete placenta previa patients with PAS.</p><p><strong>Methods: </strong>One hundred and thirty-eight patients were diagnosed as PAS from January 2016 to December 2023 in the retrospective study. The patients were divided into two groups according to the estimated blood loss volume: MH group (estimated blood loss >2000 mL) and non-MH group (estimated blood loss ≤2000 mL). After adjusting for PAS grade and clinical variables, the correlation between placenta area in S2, cervical area and MH were evaluated with multivariate analysis. The evaluation capabilities of indicators were assessed using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>The placenta area in S2 of the MH group was significantly higher than that of the group without MH (<i>P</i><0.001), on the contrary, cervical area was significantly lower in PAS patients with MH than that of the group without MH (<i>P</i><0.001). After adjusting for the type of PAS, a placenta area in S2 ≥45 cm² (OR, 4.805; 95% CI, 2.776-8.794; <i>P</i><0.05) and a cervical area <4.0 cm² (OR, 4.015; 95% CI, 1.905-7.862; <i>P</i><0.05) were independently associated with an increased risk of MH. A positive association was found between the placental area and the amount of blood loss (r=0.748), and negative linear was found between the cervical area and the amount of blood loss (r=-0.682), between cervical area and placenta area (r=-0.575). Combined with placental area in S2 and cervical area, the sensitivity, specificity, and the area under the curve (AUC) for the predictive MH were 89.237%, 91.548%, and 0.910 (95% CI 0.858 ~ 0.963), respectively.</p><p><strong>Conclusion: </strong>The placenta area in S2 and cervical area measured by MRI show potential utility in identifying MH among patients with PAS, which may assist in preoperative risk stratification. These preliminary results require validation in future studies.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"582651"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Prenatal Prediction Model for Neonatal Hyperbilirubinemia Based on Maternal Factors: Revealing Heterogeneous Risk Profiles Across Gestational Age Subgroups.","authors":"Jiawen Chen, Jin Wang, Jiandong Chen, Liangzhao Wu, Donglian Xiong","doi":"10.2147/IJWH.S584032","DOIUrl":"https://doi.org/10.2147/IJWH.S584032","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hyperbilirubinemia is common, and current risk assessment depends largely on postnatal monitoring. A prediction model using only antenatal maternal factors could enable earlier identification, especially if it accounts for differences across gestational age (GA) subgroups.</p><p><strong>Methods: </strong>This single-center case-control study enrolled 1967 subjects. After screening for significant differences in baseline characteristics and excluding multicollinearity, independent predictors were identified via univariate and multivariate logistic regression. Several machine learning models were developed and evaluated based on their area under the curve (AUC), sensitivity, specificity, accuracy, etc. Interaction analysis was performed, and subgroup-specific models were built for early-term and full-term subgroups. The SHAP analysis was employed to rank feature importance.</p><p><strong>Results: </strong>Key independent antenatal predictors included GA, mode of delivery, maternal hypothyroidism, infection, mean corpuscular hemoglobin concentration (MCHC), alkaline phosphatase (AKP), albumin (ALB), and total bilirubin (TBIL). A significant interaction was found between GA and ALB (<i>P</i> for interaction=0.004). Logistic regression was selected as the optimal model (AUC: 0.661[0.617-0.704]) for its generalizability and clinical utility. Subgroup analysis revealed distinct risk factor patterns; for instance, the SHAP analysis indicated that ALB and mode of delivery were the two most significant predictive factors in the full-term group, while mode of delivery and platelets were the key factors in the early-term group.</p><p><strong>Conclusion: </strong>This study developed a predictive model for neonatal hyperbilirubinemia using an exploratory analysis of routine antenatal maternal factors. We demonstrated that GA significantly modified risk profiles, necessitating stratified assessment. However, the clinical relevance of certain non-traditional laboratory predictors requires further validation.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"584032"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Mortality Transition and Subnational Inequities in China, 1990-2023: Comparative Analysis of GBD 2023 and National Surveillance Data.","authors":"Jian-Bo Wei, Huayu Huang, Jie Zhang, Xiao-Fei Li, Yuan Xu, Mingwei Lv, Liang-Sheng Fan","doi":"10.2147/IJWH.S600634","DOIUrl":"https://doi.org/10.2147/IJWH.S600634","url":null,"abstract":"<p><strong>Background: </strong>The maternal mortality ratio (MMR) is a core indicator of health-system performance and equity. In China, interpretation of recent maternal mortality trends is increasingly influenced by differences between modeled global estimates and national surveillance data. We aimed to characterize the maternal mortality transition and subnational inequities in China from 1990 to 2023 by comparing Global Burden of Disease (GBD) 2023 estimates with data from the National Maternal Mortality Surveillance System (NMMSS).</p><p><strong>Methods: </strong>We integrated model-based estimates from the GBD 2023 with real-world data from China's NMMSS. Assessment focused on key burden metrics, including disability-adjusted life years, MMR, mortality and incidence. Joinpoint regression was used to identify temporal trend changes. Scenario-based projections and Bayesian age-period-cohort (BAPC) models were applied to forecast progress toward the \"Healthy China 2030 target\". Subnational inequalities in maternal healthcare service coverage were also examined.</p><p><strong>Results: </strong>GBD estimates showed China's MMR declined from 121.9 (1990) to 10.7 (2023) per 100,000 live births, while NMMSS reported 15.1 per 100,000 live births in 2023. According to GBD, the leading cause shifted from maternal hemorrhage to indirect disorders, whereas NMMSS consistently identified obstetric hemorrhage as the primary cause. The urban-rural disparity narrowed substantially, but subnational inequities persisted, particularly in western provinces. The MMR rapid decline during 2004-2015 was followed by a plateau. Scenario-based projections indicate that sustaining recent progress would enable China to achieve the Healthy China 2030 target (MMR <12 per 100,000 live births).</p><p><strong>Conclusion: </strong>China has made remarkable progress in maternal health and significantly reduced urban-rural disparities. However, critical differences between GBD estimates and NMMSS data underscore the need for improved local data collection. Targeted strategies, such as integrating cardiovascular risk screening in eastern provinces and strengthening obstetric emergency capacity in western regions, are essential to further reduce maternal mortality and achieve the Healthy China 2030 goal.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"600634"},"PeriodicalIF":2.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red Cell Distribution Width-to-Albumin Ratio as a Predictor of Preeclampsia in Advanced Maternal Age: A Retrospective Cohort Study.","authors":"Nuoni Wang, Shihao Liu, Wenjun Zhou, Liangqing Ge, Sulan Huang","doi":"10.2147/IJWH.S596658","DOIUrl":"https://doi.org/10.2147/IJWH.S596658","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a leading cause of maternal and perinatal morbidity, particularly among women of advanced maternal age. Simple and inexpensive laboratory markers associated with preeclampsia risk remain of clinical interest in this population. The red cell distribution width‑to‑albumin ratio (RAR), an integrated index of erythrocyte anisocytosis and hypoalbuminemia, has emerged as a marker of systemic inflammation and vascular stress in cardiovascular and critical care settings. Its relevance to preeclampsia is unknown.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 2296 women aged ≥35 years with singleton pregnancies delivering at a tertiary hospital between 2013 and 2023. Blood samples for red cell distribution width (RDW) and serum albumin were obtained during early pregnancy prenatal visits at 11-12 weeks of gestation. RAR was calculated as red cell distribution width (RDW, %) divided by serum albumin (g/L) and analyzed as RAR multiplied by 10 (RAR×10) and by tertiles. Preeclampsia was confirmed after 20 weeks of gestation. Multivariable logistic regression, restricted cubic splines, and prespecified subgroup analyses were performed to evaluate associations between RAR and preeclampsia.</p><p><strong>Results: </strong>The mean age was 37.78 ± 2.67 years; 328 women (14.29%) developed preeclampsia. Preeclampsia prevalence increased across RAR tertiles (9.95%, 14.14%, 18.75%; <i>p</i><0.001). Each one‑unit increase in RAR×10 was associated with higher odds of preeclampsia (adjusted OR 1.16, 95% CI 1.04-1.30). Compared with the lowest tertile, adjusted OR was 1.38 (95% CI 0.98-1.94) for tertile 2 and 1.89 (95% CI 1.35-2.64) for tertile 3, respectively (<i>p</i> for trend<0.001). Restricted cubic spline analysis suggested a non-linear, J‑shaped association, with risk rising steeply above RAR×10≈3.95. The association appeared stronger among women with obesity.</p><p><strong>Conclusion: </strong>Higher RAR measured in early pregnancy was associated with increased preeclampsia risk in AMA women and may serve as a simple biomarker for early risk stratification.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"596658"},"PeriodicalIF":2.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}