Journal of women's health最新文献

{"title":"Analysis of Alcohol Use and Alcohol Use Disorder Trends in U.S. Active-Duty Service Women.","authors":"Stephanie Tower, Amanda Banaag, Rachel Sayko Adams, Miranda Lynn Janvrin, Tracey Pérez Koehlmoos","doi":"10.1089/jwh.2023.0497","DOIUrl":"10.1089/jwh.2023.0497","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Alcohol use (AU) and disorders (AUDs) have been increasing among women over the past decade, with the largest increases among women of child-bearing age. Unprecedented stressors during the COVID-19 pandemic may have impacted AU for women with and without children. Little is known about how these trends are impacting women in the military. <b><i>Methods:</i></b> Cross-sectional study of active-duty service women (ADSW) in the U.S. Army, Air Force, Navy, and Marine Corps during fiscal years (FY) 2016-2021. We report the prevalence of AU and AUD diagnoses by FY, before/during the COVID-19 pandemic (2016-2019; 2020-2021, respectively), and by parental status. Log-binomial and logistic regressions examined associations of demographics, military, and family structure characteristics, with AU and AUD, during pre-COVID-19 and COVID-19 timeframes. <b><i>Results:</i></b> We identified 281,567 ADSW in the pre-COVID-19 period and 237,327 ADSW in the during COVID-19 period. The prevalence of AU was lower during the COVID-19 period (47.9%) than during the pre-COVID-19 period (63.0%); similarly, the prevalence of AUD was lower during the COVID-19 period (2.7%) than during the pre-COVID period (4.0%). ADSW with children had larger percentage decreases during the COVID-19 period. ADSW with children had a consistently lower prevalence and odds of AUD compared with ADSW without children in the pre- and during COVID-19 periods. <b><i>Conclusion:</i></b> Decreasing trends in AU and AUD among ADSW were unexpected. However, the prevalence of AU and AUD may not have been accurately captured during the COVID-19 period due to reductions in access to care. Continued postpandemic comparison of AU/AUD among women by parental status and demographic factors may guide targeted health efforts.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"60-69"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866617","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":"Exploring Reasons for Loss to Follow-up in Pregnancy of Unknown Location: A Mixed-Methods Study.","authors":"Anne N Flynn, Arden McAllister, Alicia Jen, Sarah Gutman, Antoinette Allen, Corinne Kete, Natasha Seth, Nathanael Koelper, Sarita Sonalkar","doi":"10.1089/jwh.2023.1146","DOIUrl":"10.1089/jwh.2023.1146","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To quantify proportions of loss to follow-up in patients presenting with a pregnancy of unknown location and explore patients' perspectives on follow-up for pregnancy of unknown location. A pregnancy of unknown location is a scenario in which a patient has a positive pregnancy test but the pregnancy is not visualized on transvaginal ultrasound. <b><i>Study Design:</i></b> We conducted a retrospective cohort study of patients with pregnancy of unknown location who presented to an urban academic emergency department or complex family planning outpatient office. We sought to calculate the proportion of patients lost to follow-up, defined as inability to contact the patient within 2 weeks. We then conducted focus groups of patients diagnosed with a pregnancy of unknown location. We used thematic analysis to identify themes related to follow-up. <b><i>Results:</i></b> We reviewed 464 charts of patients diagnosed with pregnancy of unknown location. The median age in this cohort was 27 with most patients identifying as Black (80%, <i>n</i> = 370) and using public insurance (67%, <i>n</i> = 315). When looking at loss to follow-up rates, Black patients experienced loss to follow-up (20%, <i>n</i> = 72) more often than White patients (4%, <i>n</i> = 2; <i>p</i> = 0.003). Focus group participants had a mean age of 31.8+/-4.8, and the majority were of Black race (<i>n</i> = 16, 72.7%). Participants identified barriers to follow-up including the long duration of management, general inconvenience, and poor communication with their health care team. Participants felt a burden of responsibility to learn about their condition and to self-advocate for their follow-up and communication of results. <b><i>Conclusions:</i></b> These data indicate that Black patients are more likely to experience loss to follow-up compared with White patients during monitoring for pregnancy of unknown location. Patients identified many barriers to follow-up and felt that successful follow-up required substantial self-efficacy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"118-124"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498389","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":"Associations Between Earlier Menarche and Fibroid Severity in Individuals Seeking Hysterectomy.","authors":"Eva Laura Siegel, Brianna VanNoy, Lauren C Houghton, Nadia Khati, Ayman Al-Hendy, Cherie Q Marfori, Ami R Zota","doi":"10.1089/jwh.2024.0403","DOIUrl":"10.1089/jwh.2024.0403","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Early menarche is associated with uterine fibroid risk, but the association between menarcheal timing and fibroid severity remains to be explored. Given the hormonal dependence of fibroids, earlier menarche may increase physical burden (e.g., number of fibroids) and/or symptoms (e.g., heavy menstrual bleeding), though the two are not always correlated. We hypothesized that individuals with earlier menarche are more likely to have severe fibroids. <b><i>Design:</i></b> We analyzed observational data using linear regression models to examine the association between earlier age at menarche and fibroid severity. <b><i>Subjects</i></b>: Individuals seeking hysterectomy (n = 110) for fibroid management at a hospital in Washington, D.C. from 2014 to 2021 as part of the Fibroids, Observational Research on Genes and the Environment study. <b><i>Exposure:</i></b> Participants recalled age at menarche during adulthood. We modeled age at menarche continuously, and we defined early menarche as menarche before 12 years in descriptive analyses. <b><i>Main Outcome Measures:</i></b> We evaluated three types of fibroid severity outcomes: self-reported symptoms using validated scales, clinical parameters (e.g., fibroid number and size), and age at hysterectomy. <b><i>Results:</i></b> In our predominantly Black sample, early menarche (i.e., <12 years) was reported by 25.5% (28/110) of participants. In adjusted linear models, earlier menarche was associated with increased symptom severity [<i>b</i> = -3.3 (95% CI: -6.05, -0.56)], younger age at hysterectomy [<i>b</i> = 0.8 (95% CI: 0.2, 1.41)], and uterine weight over 250 g (compared with ≤250 g) [<i>b</i> = -0.05 (95% CI: -0.11, -0.00)], but not with other measures of physical fibroid burden. <b><i>Conclusion:</i></b> Earlier menarche was associated with measures of fibroid severity. Prolonged exposure to estrogen <i>via</i> early menarche may accelerate the tumorigenesis process. Patient-reported symptoms as well as measures of physical burden should be considered when investigating the etiology of fibroid-related morbidity.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"235-241"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468907","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":"Cancer Diagnosis During Pregnancy and Livebirth Outcomes in the Adolescent and Young Adult Horizon Study.","authors":"Caroline Cochrane, Chelsea Anderson, Sara Mitra, Laura Green, Christopher D Baggett, Jennifer E Mersereau, Darios Getahun, Marilyn L Kwan, Chun R Chao, Lawrence H Kushi, Hazel B Nichols","doi":"10.1089/jwh.2024.0064","DOIUrl":"10.1089/jwh.2024.0064","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To describe patterns of cancer treatment and live birth outcomes that followed a cancer diagnosis during pregnancy. <b><i>Study Design:</i></b> The Adolescent and Young Adult (AYA) Horizon Study is an observational study evaluating outcomes in survivors of the five most common types of cancer in this age group (15-39 years old). Of the 23,629 individuals identified diagnosed with breast, lymphoma, thyroid, melanoma, or gynecological cancer in North Carolina (2000-2015) and California (2004-2016), we identified 555 live births to individuals who experienced cancer diagnosis during pregnancy. Births to individuals diagnosed with cancer during pregnancy were matched ∼1:5 on maternal age and year of delivery to live births to individuals without a cancer diagnosis (<i>N</i> = 2,667). Multivariable Poisson regression was used to compare birth outcomes between pregnancies affected by a cancer diagnosis and unaffected matched pregnancies. <b><i>Results:</i></b> Cancer diagnosis during pregnancy was associated with an increased risk of preterm delivery (prevalence ratio [PR] 2.70; 95% confidence interval [CI] 2.24, 3.26); very preterm delivery (PR 1.74; 95% CI 1.12, 2.71); induction of labor (PR 1.48; 95% CI 1.27, 1.73); low birth weight (PR 1.97; 95% CI 1.55, 2.50); and cesarean delivery (PR 1.18; 95% CI 1.04, 1.34) but not associated with low Apgar score (PR 0.90; 95% CI 0.39, 2.06). In our sample, 41% of patients received chemotherapy, half of whom initiated chemotherapy during pregnancy, and 86% received surgery, 58% of whom had surgery during pregnancy. Of the 19% who received radiation, all received radiation treatment following pregnancy. <b><i>Conclusion:</i></b> We identified an increased risk of birth outcomes, including preterm and very preterm delivery, induction of labor, low birth weight, and cesarean delivery, to those experiencing a cancer diagnosis during pregnancy. This analysis contributes to the available evidence for those experiencing a cancer diagnosis during pregnancy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"27-35"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Health Record Concordance with Survey-Reported Military Sexual Trauma Among Younger Veterans: Associations with Health Care Utilization and Mental Health Diagnoses.","authors":"Allison E Gaffey, Matthew M Burg, Melissa Skanderson, Jason C Deviva, Cynthia A Brandt, Lori A Bastian, Sally G Haskell","doi":"10.1089/jwh.2023.0993","DOIUrl":"10.1089/jwh.2023.0993","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Military sexual trauma (MST) is more common among post-9/11 Veterans and women versus older Veterans and men. Despite mandatory screening, the concordance of electronic health record (EHR) documentation and survey-reported MST, and associations with health care utilization and mental health diagnoses, are unknown for this younger group. <b><i>Materials and Methods:</i></b> Veterans' Health Administration (VHA) EHR (2001-2021) were merged with data from the observational, nationwide WomenVeterans Cohort Study (collected 2016-2020, <i>n</i> = 1058; 51% women). Experiencing MST was defined as positive endorsement of sexual harassment and/or assault. From the EHR, we derived Veterans' number of primary care and mental health visits in the initial two years of VHA care and diagnoses of posttraumatic stress disorder (PTSD), depression, and anxiety. First, the concordance of EHR MST screening and survey-reported MST was compared. Next, multivariate analyses tested the cross-sectional associations of EHR screening and survey-reported MST with Veterans' health care utilization, and compared the likelihood of PTSD, depression, and anxiety diagnoses by MST group, while covarying demographics and service-related characteristics. With few MST cases among men, multivariate analyses were only pursued for women. <b><i>Results:</i></b> Overall, 29% of women and 2% of men screened positive for MST in the EHR, but 64% of women and 9% of men had survey-reported MST. Primary care utilization was similar between women with concordant, positive MST reports in the EHR and survey versus those with survey-reported MST only. Women with survey-reported MST only were less likely to have a PTSD or depression diagnosis than those with concordant, positive MST reports. There was no group difference in women's likelihood of anxiety. <b><i>Conclusions:</i></b> EHR MST documentation is discordant for many post-9/11 Veterans-both for men and women. Improving MST screening and better supporting MST disclosure are each critical to provide appropriate and timely care for younger Veterans, particularly women.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"125-132"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469104","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":"Trends in Adverse Pregnancy Events Among Veterans: Racial Disparities and Care Coordination.","authors":"Lynette Hamlin","doi":"10.1089/jwh.2024.0690","DOIUrl":"10.1089/jwh.2024.0690","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"163"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290208","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":"Practical Considerations for Using Continuous Glucose Monitoring in Patients with Gestational Diabetes Mellitus.","authors":"Kristin Castorino, Celeste Durnwald, Stacey Ehrenberg, Nicole Ehrhardt, Dianna Isaacs, Carol J Levy, Amy M Valent","doi":"10.1089/jwh.2023.0864","DOIUrl":"10.1089/jwh.2023.0864","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) is the most prevalent metabolic complication during pregnancy. GDM is associated with adverse perinatal, neonatal, and long-term health consequences. Studies have demonstrated that the use of continuous glucose monitoring (CGM) reduces the incidence of maternal and neonatal complications in pregnant women with type 1 diabetes. Although the use of CGM in GDM has not been well studied, a growing body of evidence is showing potential benefits in the GDM population. This article discusses the advantages and challenges of CGM and provides practical guidelines for using this technology in the GDM population.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"10-20"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391545","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":"Attitudes and Experiences Regarding Communication About Maternal Vaccination: Qualitative Findings from Non-Hispanic Black Pregnant People.","authors":"Isabel Mendez, Veronica G Gilliard, Laura A Randall, Angela Robertson","doi":"10.1089/jwh.2024.0950","DOIUrl":"10.1089/jwh.2024.0950","url":null,"abstract":"<p><p>Comprehensive prenatal care incorporates recommended vaccines to help protect the mother, the pregnancy, and the infant from adverse health outcomes and severe illness from vaccine preventable diseases (VPDs). However, vaccinations during pregnancy remain underutilized, often influenced by concerns about vaccine safety and low perception of disease risk. Self-reported vaccine hesitancy among pregnant people in the United States has significantly increased in the last few years, and influenza and Tdap (tetanus, diphtheria, and pertussis) vaccination rates have declined. Furthermore, the number of vaccines routinely recommended during pregnancy has expanded. Communication strategies tailored to pregnant people may help build vaccine confidence among pregnant people and their health care providers. While characteristics and perceptions associated with hesitancy to vaccinate during pregnancy are documented in existing literature, more information is needed on promising communication practices preferred by subgroups of pregnant persons, particularly Black pregnant people who have higher rates of illness from VPDs and greater risk of pregnancy-related complications. This article summarizes literature on the current landscape of prenatal vaccination, discusses qualitative findings from focus groups with non-Hispanic Black pregnant people, and describes promising practices for communicating with this group about vaccination. Promising practices include specifying the benefits of vaccination for both the pregnant person and the infant, outlining potential risks, and emphasizing the overall importance of vaccination during pregnancy, while also acknowledging that many non-Hispanic Black pregnant people may have health concerns they perceive as superseding vaccination.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers with Breastfeeding Difficulty Report Increased Depressive Symptoms and Impaired Maternal-Infant Bonding on Social Media.","authors":"Elizabeth A Wright, Aashna Mehta, Anita L Nelson","doi":"10.1089/jwh.2024.0151","DOIUrl":"10.1089/jwh.2024.0151","url":null,"abstract":"<p><p><b><i>Background:</i></b> Protection against postpartum depression is a commonly cited maternal benefit of breastfeeding. However, recent studies have found that negative breastfeeding experiences may actually increase the risk of depressive symptoms. <b><i>Objective:</i></b> To investigate women's self-reported associations between breastfeeding experiences and depressive symptoms on a social media platform. <b><i>Study Design:</i></b> An electronic search was conducted on Reddit of all original user posts using keywords \"breastfeeding\" and \"depression\" from February 2013 to July 2021. Relevant posts and corresponding comments were manually extracted, evaluated for inclusion and exclusion criteria, and analyzed for thematic content. <b><i>Results:</i></b> In total, 584 entries was analyzed. Mothers most frequently described difficulty breastfeeding as the cause of new onset mental health symptoms (53%); however, mothers breastfeeding without difficulty were also susceptible (20%). Mothers also reported exacerbated preexisting mental health symptoms-predominantly related to difficulty breastfeeding (17%), but again, others experienced no difficulty (6%). Common words included among all entries were \"guilt\" (17%), \"fail\" (14%), \"pressure\" (7%), \"shame\" (6%), and \"alone\" (6%). Among mothers mentioning bonding (<i>n</i> = 99), 58% reported that breastfeeding inhibited infant bonding, versus 1% enhanced bonding; furthermore, 63% reported increased bonding after switching to formula versus 8% unchanged and 6% decreased bonding. Nearly one-quarter (23%) of all posts described inadequate breastfeeding counseling. Finally, 9% of all posts reported a negative experience with health care providers versus 6% a positive experience. <b><i>Conclusions:</i></b> Mothers struggling to breastfeed may not experience the classically described benefits of breastfeeding, instead experiencing increased depressive and other mental health symptoms and impaired maternal-infant bonding. Furthermore, limited provider disclosure about potential breastfeeding challenges and alternatives to breastfeeding may exacerbate mental health symptoms associated with breastfeeding difficulties. Balanced information should be presented to mothers contemplating breastfeeding in order to minimize maternal perceptions of \"failure.\"</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"251-260"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468912","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":"Change in Postpartum Visit and Contraception Rates Pre-COVID-19 to Post-Lockdown in Six U.S. Federally Qualified Health Centers.","authors":"Rebecca K Campbell, Emma Gray, Rachel Caskey, Cristina Barkowski, Jena Wallander Gemkow, Nivedita Mohanty, Kristin Rankin, Sadia Haider","doi":"10.1089/jwh.2024.0691","DOIUrl":"10.1089/jwh.2024.0691","url":null,"abstract":"<p><p><b><i>Background:</i></b> Postpartum care, including contraception, benefits maternal health and decreases mortality, which increased in the United States with COVID-19. Pandemic disruptions to postpartum health care access in vulnerable populations are not well understood. We utilize electronic health record (EHR) data for prenatal patients (<i>n</i> = 2,265) at six urban Federally Qualified Health Centers (FQHCs) from one year prepandemic (January 1, 2019) through one year after the first stay-at-home orders (\"lockdown\") (March 31, 2021). <b><i>Objective:</i></b> We investigated (1) changes in rates of postpartum visit (PPV) and postpartum contraception receipt in the post-lockdown versus prepandemic periods and (2) characteristics predictive of differential changes in PPV and contraception rates. <b><i>Materials and Methods:</i></b> Visit and prescription records from EHR were used to classify if patients received PPV and most/moderately effective contraception within 60 days postpartum, analyzed separately and as a composite variable: PPV and contraception, PPV only, or no PPV. Risk differences comparing post-lockdown with pre-COVID-19 pandemic were estimated using binomial regression and generalized logistic regression models adjusted for age, race/ethnicity, language, and clinical site. Effect modification by sociodemographic and clinical covariates was examined. <b><i>Results:</i></b> Total patient volume fell 21% in the post-lockdown versus pre-COVID-19 period. Rates of PPV decreased in absolute terms by 9.6 (95% confidence interval: -13.6, -5.6) and contraception by 8.1 (-13.3, -2.8) percentage points. After adjustment, PPV and contraception decreased by 9.3 percentage points (-13.1, -5.4), while PPV only was stable (-0.4 [-4.3, 3.6]). <b><i>Conclusions:</i></b> These findings suggest a substantial impact of the COVID-19 pandemic on postpartum care in FQHCs and community health centers. Supply and demand drivers require further examination to inform strategies to improve postpartum care access and subsequent maternal health outcomes.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882531","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}