Journal of women's health最新文献

{"title":"The Association of Menopausal Age with Sex Hormones and Anthropometric Measures Among Postmenopausal Women in the Multi-Ethnic Study of Atherosclerosis Study.","authors":"Imo A Ebong, Machelle Wilson, Susan B Racette, Duke Appiah, Pamela J Schreiner, Matthew Allison, Karol Watson, Alain G Bertoni, Erin D Michos","doi":"10.1089/jwh.2024.0508","DOIUrl":"https://doi.org/10.1089/jwh.2024.0508","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> We investigated associations of menopausal age category with body mass index (BMI), waist circumference, waist-hip ratio, and waist-height ratio. We also explored the moderating effect of anthropometric measures on associations of menopausal age category with prespecified sex hormones: estradiol, dehydroepiandrosterone (DHEA), sex hormone-binding globulin, bioavailable testosterone, and total testosterone-estradiol (T/E) ratio. <b><i>Methods:</i></b> In this cross-sectional study, we included 2,436 postmenopausal women from the Multi-Ethnic Study of Atherosclerosis who had menopausal age, anthropometric, and sex hormone data at baseline. Menopausal age was categorized as <45 years (early menopause), 45-49 years, 50-54 years (referent), and ≥55 years (late menopause). Linear models were used for analysis. <b><i>Results:</i></b> The mean (standard deviation) age was 64.7 (9.2) years. After multivariable adjustment, women who experienced late menopause had higher waist circumference (2.28 cm), waist-hip ratio (0.013 units), and waist-height ratio (0.014 units) but not BMI than those in the referent category. The interaction terms between menopausal age category and anthropometric measures were not significant for prespecified sex hormones (all <i>P_interaction</i> >0.05). When compared with the referent category, T/E ratio was 21% (4.72 - 39.8%) higher among women with late menopause while DHEA levels were 9% (1 - 16%) higher among women who experienced menopause between 45 and 49 years in multivariable adjusted models. <b><i>Conclusion:</i></b> Women with late menopause had higher abdominal adiposity but not generalized adiposity when compared with those who experienced menopause between 50 and 54 years of age. Androgenicity was higher among women who experienced menopause between 45 and 49 years of age and those with late menopause, based on DHEA and T/E ratios, respectively.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971464","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 Stillbirth Calamity: Reenergized Congressional Relief Efforts.","authors":"Eli Y Adashi, Daniel P O'Mahony, Glenn I Cohen","doi":"10.1089/jwh.2024.1012","DOIUrl":"https://doi.org/10.1089/jwh.2024.1012","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971466","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":"Health Care Utilization Among Post-Stroke Women: Associations with Perceived Racism.","authors":"Molly Jacobs, Angela Miles, Charles Ellis","doi":"10.1089/jwh.2024.0944","DOIUrl":"https://doi.org/10.1089/jwh.2024.0944","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Post-stroke health care is crucial for recovery and preventing complications. This study explored the association between perceived racism and health care utilization among post-stroke women, highlighting the disparate utilization patterns of marginalized racial/ethnic women. <b><i>Methods:</i></b> The 2022 Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System Survey was used to characterize health care utilization among women with stroke diagnoses across different racial groups: White, Black, Hispanic, and Asian/Asian, Islander, Alaska Native/Other/Multiracial. Logistic regression analysis characterized the association between three types of health care utilizations-having a health insurance plan, a health care provider, and receiving a routine checkup-and perceived race-based treatment in the medical sector. <b><i>Results:</i></b> The sample included 10,184 post-stroke women: 75.01% White, 12.42% Black, 6.77% Hispanic, and 5.80% Asian/AIAN/Other/multiracial. Only 2.95% of White women reported worse treatment, compared with 10.74% of Black, 13.19% of Asian/AIAN/Other/multiracial, and 8.85% of Hispanic women. Regression analysis revealed that Hispanic women (odds ratio [OR] = 0.61, confidence interval [CI] = 0.17, 0.84) were less likely to have a health plan, though those receiving similar or better treatment had higher odds (OR = 1.55, CI = 1.62, 3.90). Black women were less likely to have a routine checkup (OR = 0.51, CI = 0.14, 0.77), but those receiving similar or better treatment had higher odds (OR = 2.72, CI = 1.64, 11.63). Women from other racial/ethnic groups, Black, and Hispanic women had lower odds of having a personal provider (ORs ranging from 0.17 to 0.69), though those receiving similar or better treatment had higher odds (ORs ranging from 1.79 to 3.39). <b><i>Conclusions:</i></b> Perceived differences in treatment in the medical sector among marginalized post-stroke women were significantly associated with lower health care utilization.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971463","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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-10","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-10","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}

{"title":"Menthol Cigarettes and Maternal Health: 2004-2022.","authors":"William Encinosa, R Burciaga Valdez","doi":"10.1089/jwh.2024.0753","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","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":"Contraception Update: A Focus on Safety and Efficacy.","authors":"Madeline Cohn, Rachel Novik, Pelin Batur","doi":"10.1089/jwh.2024.1063","DOIUrl":"https://doi.org/10.1089/jwh.2024.1063","url":null,"abstract":"<p><p>This clinical update serves as a brief summary of recently published and potentially practice changing journal articles. We review recent publications related to contraceptive safety and efficacy. The article discusses updated medical eligibility recommendations, effectiveness of progestin-only pills (including the newly approved over-the-counter pill), safety of estrogen containing contraceptives in those with migraine, topiramate interactions with hormonal contraception, and the use of nonsteroidal antiinflammatory drugs (NSAIDs) with oral emergency contraception to improve efficacy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950764","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":"Racial and Ethnic Disparities in Cervical Insufficiency, Cervical Cerclage, and Preterm Birth.","authors":"Hayley E Miller, Jonathan A Mayo, Ravali A Reddy, Stephanie A Leonard, Henry C Lee, Sanaa Suharwardy, Deirdre J Lyell","doi":"10.1089/jwh.2024.0088","DOIUrl":"10.1089/jwh.2024.0088","url":null,"abstract":"<p><p><b><i>Background:</i></b> The frequency of cervical insufficiency differs among the major racial and ethnic groups, with limited data specific to Asian American and Native Hawaiian/Pacific Islander (AANHPI) subpopulations. We assessed cervical insufficiency diagnoses and related outcomes across 10 racial and ethnic groups, including disaggregated AANHPI subgroups, in a large population-based cohort. <b><i>Study Design:</i></b> We performed a retrospective cohort study of all singleton births between 20-42 weeks' gestation in California from 2007 to 2018. Logistic regression models were performed to estimate the odds of cervical insufficiency and, among people with cervical insufficiency, the odds of cerclage and preterm birth according to self-reported race and ethnicity. <b><i>Results:</i></b> Among 5,114,470 births, 38,605 (0.8%) had a diagnosis code for cervical insufficiency. Compared with non-Hispanic White people, non-Hispanic Black people had the highest odds of cervical insufficiency (adjusted odds ratio [aOR] 3.07; 95% confidence interval [CI], 2.97, 3.18), for cerclage placement and higher odds for preterm birth. Disaggregating AANHPI subgroups showed that Indian people had the highest odds (aOR 1.94; 95% CI, 1.82, 2.07) of cervical insufficiency and had significantly higher odds of cerclage without increased odds of preterm birth; Southeast Asian people had the highest odds of preterm birth. <b><i>Conclusion:</i></b> Within a large, diverse population-based cohort, non-Hispanic Black people experienced the highest rates of cervical insufficiency, and among those with cervical insufficiency, had among the highest rates of cerclage and preterm birth. Among AANHPI subgroups specifically, Indian people had the highest rates of cervical insufficiency and cerclage placement, without increased rates of preterm birth; Southeast Asian people had the highest rates of preterm birth, without increased rates of cerclage. Disaggregating AANHPI subgroups identifies important differences in obstetric risk factors and outcomes.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"70-77"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457703","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":"Prenatal and Postpartum Home Visits and Postpartum Contraceptive Use: A Cross-Sectional Analysis.","authors":"Sydney R Archer, Kristin M Wall, Melissa J Kottke","doi":"10.1089/jwh.2023.1115","DOIUrl":"10.1089/jwh.2023.1115","url":null,"abstract":"<p><p><b><i>Background:</i></b> The postpartum period is a time of unmet contraceptive need for many women. Home visits by a health care worker during pregnancy or after delivery could increase postpartum contraceptive use and decrease barriers to accessing postpartum care. This study investigated the association between prenatal or postpartum home visits and postpartum contraceptive use using a large sample of U.S. women from 41 states. <b><i>Subjects and Methods:</i></b> We conducted a cross-sectional analysis using weighted survey data from the 2012-2015 Phase 7 Pregnancy Risk Assessment and Monitoring Systems Core and Standard Questionnaires. Descriptive statistics and multivariate logistic regression models estimated the association between having a prenatal or postpartum home visit and self-reported postpartum contraceptive use. <b><i>Results:</i></b> Of 141,296 women, approximately 21% received prenatal or postpartum home visits and 79% used postpartum contraception. After controlling for sociodemographic, reproductive, and health-related factors, women who received prenatal or postpartum home visits had a higher odds of postpartum contraception use (adjusted odds ratio 1.08, 95% confidence interval 1.02-1.15, <i>p</i> = 0.009). Women who were older, were minority race, had less than a high school education, received inadequate prenatal care, experienced partner abuse during pregnancy, or experienced multiple stressors during pregnancy had a lower odds of postpartum contraception use in adjusted analyses controlling for home visitation. <b><i>Conclusion:</i></b> Given the benefits of recommended interpregnancy intervals to both the mother and the baby, adding formal contraceptive counseling and offering a variety of postpartum contraceptive methods in the home could further strengthen home visitation programs in the United States and may support women in achieving their reproductive goals.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"85-94"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288223","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":"Making Progress on Regionalized Maternal Risk-Appropriate Care.","authors":"Jennifer Vanderlaan","doi":"10.1089/jwh.2024.0889","DOIUrl":"10.1089/jwh.2024.0889","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"8-9"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503019","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}