Journal of women's health最新文献

{"title":"Postpartum Depression in Patients with Chronic Migraine: A Retrospective, Observational Analysis.","authors":"Rachel H Linfield, Addie M Peretz, Leon S Moskatel","doi":"10.1089/jwh.2024.0955","DOIUrl":"https://doi.org/10.1089/jwh.2024.0955","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To evaluate how migraine impacts the risk for postpartum depression (PPD) in women of reproductive age as well as the effect of comorbidities on this risk. <b><i>Methods:</i></b> This is a retrospective observational study in a tertiary neurology center involving 6248 women with migraine and 4154 women without migraine between the ages of 18 and 45 seen from January 1, 2017, to January 30, 2024. The primary outcome was the odds ratio (OR) for PPD in migraine relative to women without migraine. Secondary outcomes included the OR for PPD in women with chronic migraine who also had comorbidities. <b><i>Results:</i></b> After adjusting for demographic factors and comorbid conditions, only chronic migraine, with and without aura, was associated with higher OR for PPD; chronic migraine without aura had the highest risk for PPD (OR: 2.13; 95% CI: 1.29 to 3.53, <i>p</i> = 0.003). In patients with chronic migraine, preeclampsia was associated with the largest OR for PPD, followed by depression, gestational diabetes, and premenstrual dysphoric disorder. Anxiety, advanced maternal age, endometriosis, and post-traumatic stress disorder were not associated with a statistically significant increase in OR for PPD. <b><i>Conclusions:</i></b> Chronic migraine, with and without aura, is associated with a higher OR for PPD relative to non-migraine controls. Patients with chronic migraine, preeclampsia, depression, gestational diabetes, and premenstrual dysphoric disorder were also associated with increased risk of PPD. These data support screening patients with both chronic migraine and these comorbidities for PPD with validated screening tools to connect them with optimal resources best.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Physical and Mental Health of Post-9/11 Female and Male Veterans: Findings from the Comparative Health Assessment Interview Research Study.","authors":"Erin K Dursa, Yasmin S Cypel, William J Culpepper, Paul A Bernhard, Aaron I Schneiderman","doi":"10.1089/jwh.2024.0605","DOIUrl":"10.1089/jwh.2024.0605","url":null,"abstract":"<p><p><b><i>Background:</i></b> Females are the fastest-growing group in the veteran population, yet there is a paucity in the literature of sex-specific results from studies of chronic disease in veterans that limit our understanding of their health issues. This study provides nationally representative estimates of the physical and mental health of females and males from the Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veteran population. <b><i>Methods:</i></b> Data from the 2018 Comparative Health Assessment Interview Research Study (CHAI), a cross-sectional nationwide survey of the health and well-being of OEF/OIF/OND veterans and a comparison sample of U.S. nonveterans, were analyzed to provide sex-stratified and deployment-stratified lifetime prevalence estimates and adjusted relative odds of physical and mental health conditions in a large population-based study of OEF/OIF/OND veterans. <b><i>Results:</i></b> Overall, female veterans were significantly more likely to report cancer, respiratory disease, irritable bowel syndrome/colitis, bladder infections, vision loss, arthritis, back/neck pain, chronic fatigue syndrome, migraine, posttraumatic stress disorder, and depression. Male veterans were significantly more likely to report obesity, diabetes, heart conditions, hypertension, high cholesterol, hearing loss, fractures, spinal cord injury, sleep apnea, and traumatic brain injury. Both males and females who deployed were significantly more likely to report adverse health outcomes than those who did not deploy. <b><i>Conclusion:</i></b> This article reports sex-stratified and deployment-stratified lifetime prevalence estimates and adjusted relative odds of physical and mental health conditions in a large population-based study of OEF/OIF/OND veterans. This study demonstrates the value of epidemiological research on female veterans and its importance in understanding the burden of disease in the female veteran population.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"513-524"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intent to Leave Associated More Strongly with Workplace Belonging Than Leadership Behaviors of Supervisor in Women Health Care Professionals.","authors":"Judith D Schaechter, Emily M Silver, Ross D Zafonte, Julie K Silver","doi":"10.1089/jwh.2024.0870","DOIUrl":"10.1089/jwh.2024.0870","url":null,"abstract":"<p><p><b><i>Background:</i></b> The attrition of health care professionals from institutions has historically been high, with reports of higher rates in women than men. High attrition jeopardizes the institution's financial stability, quality of patient care, and scholarly contributions to advancing health care. The disproportionate loss of women reduces the diversity of perspectives and skills needed to meet patient needs. Attrition risk has been demonstrated to relate to both the leadership behaviors of supervisors and the sense of belonging in the workplace. Toward informing health care institutions about strategies for curtailing high attrition, we sought to assess the relative strength of the association of attrition risk with leadership behaviors of supervisors versus workplace belonging. <b><i>Methods:</i></b> Attendees of a continuing education course on women's leadership skills in health care were surveyed about the intent to leave (ITL) their institution within 2 years, perceived leadership behaviors of their supervisor, and experiences of workplace belonging. Dimensions of workplace belonging were identified by factor analysis. The strength of association of ITL with supervisor's leadership behaviors and each workplace belonging dimension was analyzed in a multivariable ordinal logistic regression model. <b><i>Results:</i></b> Women comprised 94% of survey participants. In the regression analysis, lower ITL was associated strongly with more frequent experiences of institutional culture supporting workplace belonging, modestly with more favorable perceptions of supervisor's leadership behaviors, and not with frequency of experiences of interpersonal relationships supporting workplace belonging. <b><i>Conclusions:</i></b> An institutional culture that supports workplace belonging is particularly important for reducing attrition risk in health care professionals. For health care institutions seeking to improve retention of its professionals and women in particular, our findings point to investing in a culture of workplace belonging that involves a diverse workforce, an environment in which its professionals feel heard, supported, and empowered and are provided strong career advancement opportunities.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"562-571"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menthol Cigarettes and Maternal Health: 2004-2022.","authors":"William Encinosa, R Burciaga Valdez","doi":"10.1089/jwh.2024.0753","DOIUrl":"10.1089/jwh.2024.0753","url":null,"abstract":"<p><p><b><i>Background:</i></b> The United States is proposing to ban menthol cigarettes. Our objective is to examine the extent of menthol smoking among pregnant women and its association with their health. <b><i>Methods:</i></b> Nationally representative study of 14,226 pregnant women aged 18-44 years using the 2004-2022 National Survey on Drug Use and Health. Multivariate regressions estimate the association between menthol smoking and emergency department (ED) and office visits, poor health, mental health, and smoking cessation. <b><i>Results:</i></b> In total, 7.0% of pregnant women smoked menthol cigarettes, 7.3% smoked nonmenthol, 11.0% recently quit, and 74.7% were nonsmoking. Lesbian/gay/bisexual women had the highest rates: 18.6% menthol and 11.0% nonmenthol. In the third trimester, 10.4% of Black women smoked menthol and 0.6% smoked nonmenthol (<i>p</i> < 0.01), whereas 5.4% of White women smoked menthol and 8.6% smoked nonmenthol (<i>p</i> < 0.01). From 2004 to 2022, maternal smoking decreased from 16.3% to 5.1%. However, the percentage of pregnant smoking women using menthol increased from 47.0% to 60.1%, with the largest increase among Hispanic women from 43.4% to 78.8% (<i>p</i> < 0.05), compared with a rate of 96.1% among Black women and 49.0% for White women. Pregnant women smoking menthol had 1.6 ED annual visits compared with 1.2 ED visits (<i>p</i> < 0.05) for nonmenthol and 0.6 ED visits (<i>p</i> < 0.05) among the nonsmoking. Among those smoking menthol, 73.7% reported mental health issues compared with 64.4% for nonmenthol. <b><i>Conclusions:</i></b> Women who smoke menthols report worse health compared with those smoking nonmenthol. Policies designed to reduce menthol smoking would improve maternal health, especially for minoritized women and those at higher risk for poor birthing outcomes.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"460-468"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Among First-Time Mothers Reporting Housing Insecurity and Food Insecurity.","authors":"Jennifer Ayline Aranda, Adrienne E Hoyt-Austin, Agatha Okobi, Margaret Fix, Melissa Chen, Eleanor Bimla Schwarz","doi":"10.1089/jwh.2024.0346","DOIUrl":"10.1089/jwh.2024.0346","url":null,"abstract":"<p><p><b><i>Background:</i></b> Despite health benefits to both infants and mothers, many are not breastfeeding as recommended by national guidelines. Prior studies examining the effects of housing insecurity and food insecurity on breastfeeding intention and duration have been limited and yielded mixed findings. <b><i>Methods:</i></b> To assess the relationship among housing insecurity, food insecurity, and breastfeeding, we conducted a secondary analysis of a cohort of nulliparous U.S.-born pregnant individuals with a singleton gestation of ≥28 weeks who completed web-based surveys on five occasions over their infant's first year of life. Upon enrollment, we screened participants for housing and food insecurity and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). We examined variations in breastfeeding intentions and practice by housing insecurity and food insecurity, controlling for demographic factors, using multivariable logistic regression. <b><i>Results:</i></b> Of 411 participants, 67 (16%) reported housing insecurity, and 48 (12%) reported food insecurity. Participants with housing insecurity were less likely to report exclusive breastfeeding at 6 months (17.9% versus 29.1%, <i>p</i> = 0.06) and significantly less likely to report any breastfeeding at 12 months (34.3% versus 56.9%, <i>p</i> = 0.003) compared to those with secure housing. In both bivariate and multivariable models, housing insecurity was significantly associated with cessation of breastfeeding before 12 months. Food insecurity was not significantly associated with breastfeeding duration or exclusivity. <b><i>Conclusions:</i></b> Housing insecurity is associated with and may adversely impact infant feeding, highlighting the need for screening and accessible and affordable family housing, with further investment in food assistance programs such as WIC.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"476-484"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequitable Screening for Pregnancy Intention by Race, Insurance, and Site of Care in Two High-Volume Urban Obstetric Hospitals.","authors":"Alice Abernathy, Miatta Goba, Markolline Forkpa, Jesse Chittams, Sunni L Mumford, Sindhu K Srinivas, Courtney A Schreiber","doi":"10.1089/jwh.2024.0859","DOIUrl":"10.1089/jwh.2024.0859","url":null,"abstract":"<p><p><b><i>Background:</i></b> In the United States, public health efforts are focused on reducing unintended pregnancy. Yet, differences in rates of unintended pregnancy, abortion, and unintended births by race are driven by a combination of patient-, health system-, and provider-related factors. Despite this complicated scaffolding underpinning pregnancy intention, patients are often screened for pregnancy intention or planning when they have a positive pregnancy test. We hypothesized screening may vary by patient and health system characteristics. <b><i>Objective:</i></b> To identify associations between patient and health system characteristics and receiving screening for pregnancy intention or planning. <b><i>Study Design:</i></b> We performed a secondary analysis of a retrospective cohort study of all singleton deliveries in 2019 at two Philadelphia hospitals. Our primary outcome was the presence or absence of pregnancy intention screening by the clinical team. We used logistic regression to determine patient and hospital characteristics associated with screening for pregnancy intention. <b><i>Results:</i></b> We identified 9,672 deliveries, 48% of births were among Black individuals, 91% were non-Hispanic, and 45% had public or no insurance; of all births, 33% were screened for pregnancy intention or planning. Patients were more likely to be asked if their pregnancy was intended if they were: Black (2.38 [2.10-2.750]) or publicly insured or uninsured (2.78 [2.43-3.20]). The hospital site where the patient received care was the primary driver of whether a patient was asked about pregnancy intention (10.59 [9.35-12.0]). After accounting for the hospital sites, patients of Black race remained significantly more likely to be screened than White patients. <b><i>Conclusions:</i></b> Inequities in pregnancy intention or planning screening were driven by differences in institutional practices and patient race. These findings underscore the need for equitable screening practices that ensure all patients receive high-quality, unbiased, and patient-centered reproductive care.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"469-475"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 SWHR Women's Health Research Agenda: Prioritizing Uterine Fibroids, Lupus, and Metabolism.","authors":"Irene O Aninye, Sarah Chew, Syreen Goulmamine","doi":"10.1089/jwh.2024.1146","DOIUrl":"10.1089/jwh.2024.1146","url":null,"abstract":"<p><p>Women face unique and multifaceted challenges throughout their lifespans, shaped by biological, societal, and health care-related factors. These challenges have led to gender disparities in disease burden, access to care, and representation in medical research, underscoring the need to increase targeted investments in women's health. Historically, research on diseases that disproportionately affect women has been underfunded, hindering progress in closing gender health gaps. In March 2024, the President of the United States signed an Executive Order on Women's Health Research and Innovation, signaling a new commitment by the federal government to prioritize women's health research and address these disparities. The Society for Women's Health Research (SWHR) has consistently led the charge to identify research gaps and advocate for evidence-based initiatives to improve the health and well-being of women. In celebration of its 35th anniversary, SWHR introduces a 2025 Women's Health Research Agenda, which outlines key priorities in the areas of uterine health, autoimmune disease, and cardiometabolic health. This agenda serves as a strategic roadmap for stakeholders to engage with critical areas of women's health, fostering collaboration and accelerating research to address the unmet needs of women across the lifespan.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"443-450"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Breast Density Educational Interventions on Mammography Screening Adherence Among Underserved Latinas: A Randomized Controlled Trial.","authors":"Jessica D Austin, Sarah M Jenkins, Vera J Suman, Jennifer L Ridgeway, Bhavika K Patel, Karthik Ghosh, Deborah J Rhodes, Bijan J Borah, Aaron D Norman, Edna P Ramos, Matt Jewett, Crystal R Gonzalez, Valentina Hernandez, Davinder Singh, Carmen Radecki Breitkopf, Celine M Vachon","doi":"10.1089/jwh.2024.0273","DOIUrl":"10.1089/jwh.2024.0273","url":null,"abstract":"<p><p><b><i>Background:</i></b> Latinas with mammographic dense breasts are at increased risk of breast cancer. This randomized controlled trial tests the effectiveness of three breast density (BD) educational approaches on adherence to subsequent mammography screening among Latinas receiving care at a Federally Qualified Health Center (FQHC). <b><i>Measure(s):</i></b> Adherence was ascertained using electronic health record and survey responses. Kaplan-Meier estimates of the time to subsequent mammogram were used to obtain adherence rates at 1- and 2-years post baseline mammogram. Cox modeling assessed whether adherence differed by patient characteristics or group assignment. <b><i>Results:</i></b> This analysis was limited to Latinas enrolled between October 27, 2016, and December 21, 2018 (<i>n</i> = 946; 66.1% <50 years of age, 53.5% with dense breasts). Adherence rates at 1 year was 24.8% increasing to 51.7% by year 2. Latinas randomized to the Promotora + brochure + letter arm (hazard ratio [HR]: 1.09 [95% confidence interval [95% CI] 0.87 to 1.36]) or brochure + letter (HR: 1.03 [95% CI 0.82 to 1.29]) arm were not more likely to be adherent to subsequent mammography compared to the letter only arm (<i>p = 0.76)</i>. Adjusting for age and study group, having more prior mammograms, being \"extremely likely\" to get an annual mammogram, and having more confidence to get an annual mammogram at baseline were significant drivers of subsequent adherence. <b><i>Conclusion:</i></b> Informational interventions targeting BD education alone are unlikely to significantly improve adherence to subsequent mammography among Latinas receiving care in FQHCs.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"491-503"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathways from Adverse Childhood Family Environment to Lower Urinary Tract Symptoms and Impact Among Women.","authors":"Sonya S Brady, Andrés Arguedas, Jared D Huling, Gerhard Hellemann, David R Jacobs, Cora E Lewis, Cynthia S Fok, Stephen K Van Den Eeden, Alayne D Markland","doi":"10.1089/jwh.2024.0790","DOIUrl":"10.1089/jwh.2024.0790","url":null,"abstract":"<p><p><b><i>Background:</i></b> To advance existing knowledge, this study examined mechanisms that may link retrospectively reported adverse childhood family environment (ACFE) to lower urinary tract symptoms and their impact (LUTS/impact), a composite variable with four levels (bladder health and mild, moderate, or severe LUTS/impact), among women (<i>n</i> = 1,026) in the Coronary Artery Risk Development in Young Adults cohort study. A prior study demonstrated that ACFE was associated with greater LUTS/impact. <b><i>Materials and Methods:</i></b> In 2000-01, the frequency of ACFE events was retrospectively assessed. In 2012-13, data on LUTS/impact were collected. Between 1985-86 and 2010-11, data on proposed mediators were collected at varying time points and averaged to form composite variables. A series of proportional odds ordinal logistic regression analyses were conducted. LUTS/impact was regressed on ACFE, adjusting for age, race, education, and parity. A single proposed mediator was added to the model at one time to determine whether the strength of the association between ACFE and LUTS/impact was attenuated. <b><i>Results:</i></b> When entered into regression models individually, life stressors, low levels of emotional support, and depressive symptoms each significantly attenuated the association between ACFE and LUTS/impact, with the association becoming nonsignificant when depressive symptoms were entered. Remaining proposed mediators (social network extensiveness, health behaviors, physiological health, cognitive function) did not mediate the association. <b><i>Conclusions:</i></b> ACFE may place women at risk for repeated or chronic episodes of experiencing life stressors, low support, and depressive symptoms during early and midlife adulthood, which in turn may place women at risk for more LUTS and impact during midlife adulthood.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"549-561"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Chronic Physical Conditions and Alcohol and Substance Use Disorders in the Preconception and Perinatal Periods.","authors":"Hilary K Brown, Tara Gomes, Andrew S Wilton, Andi Camden, Astrid Guttmann, Cindy-Lee Dennis, Joel G Ray, Simone N Vigod","doi":"10.1089/jwh.2024.0757","DOIUrl":"10.1089/jwh.2024.0757","url":null,"abstract":"<p><p><b><i>Background:</i></b> Chronic physical conditions (CPC) and alcohol and substance use disorders (SUD) frequently co-occur, but this has not been examined perinatally. We explored the combined effects of CPC and prepregnancy SUD on perinatal SUD-related adverse events and outpatient care. <b><i>Materials and methods:</i></b> This population-based study comprised 77,474 people with and 664,751 without CPC with a birth in Ontario, Canada, 2013-2020. We measured the prevalence of prepregnancy SUD in both groups. We then calculated adjusted relative risks (aRR) of: (1) SUD-related adverse events (toxicity resulting in acute care use/death, or other SUD-related acute care use) and (2) outpatient care for SUD between conception and 365 days postpartum, comparing individuals with prepregnancy CPC and SUD (CPC + SUD), and those with CPC or SUD alone, to those with neither condition. Finally, adjusted relative excess risk due to interaction (aRERI) was calculated to quantify excess risk of the outcomes associated with CPC + SUD, wherein RERI > 0 indicated positive interaction. <b><i>Results:</i></b> aRRs of perinatal SUD-related adverse events were 26.79 (95% confidence interval [CI]: 23.12, 31.04) for people with CPC + SUD, 22.09 (95% CI: 19.59, 24.91) for SUD alone, and 2.01 (95% CI: 1.78, 2.27) for CPC alone-each relative to neither condition. There was evidence of positive interaction for CPC + SUD (aRERI: 3.69, 95% CI: 1.13, 6.46). Similar elevated aRRs were observed for perinatal outpatient care for SUD, but without a positive interaction for people with CPC + SUD. <b><i>Conclusion:</i></b> As people with both CPC and SUD have the highest risk of perinatal SUD-related adversity, they may need greater preconception and perinatal support.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"504-512"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}