Journal of women's health最新文献

{"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":"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":"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}

{"title":"Severe Maternal Morbidity and Other Perinatal Complications Among Black, Hispanic, and White Birthing Persons With and Without Physical Disabilities.","authors":"Willi Horner-Johnson, Bharti Garg, Jonathan M Snowden, Aaron B Caughey, Jaime Slaughter-Acey, Ilhom Akobirshoev, Monika Mitra","doi":"10.1089/jwh.2024.0694","DOIUrl":"https://doi.org/10.1089/jwh.2024.0694","url":null,"abstract":"<p><p><b><i>Background:</i></b> People with physical disabilities are at increased risk of adverse perinatal outcomes, including severe maternal morbidity (SMM). Risks may be even greater for disabled people in minoritized racial or ethnic groups, but little is known about this intersection. <b><i>Methods:</i></b> We analyzed linked hospital discharge and vital records data from California, 2008-2020. We identified physical disabilities using diagnosis codes for maternal congenital anomalies, major injuries, musculoskeletal disorders, or nervous system disorders. We compared birthing persons in five groups (Black and Hispanic with and without physical disabilities, White with physical disabilities) to a reference group of non-Hispanic Whites without disabilities. We used Poisson regression to assess associations with SMM and other outcomes, with and without adjusting for sociodemographic and clinical covariates. <b><i>Results:</i></b> Disabled Black and Hispanic birthing persons had particularly high relative risks (RRs) of SMM (Black disabled RR = 6.13, 95% confidence interval [CI]: 4.94, 7.61; Hispanic disabled RR = 3.67, 95% CI: 3.29, 4.10) as compared with nondisabled White persons. These risks were greater than those for nondisabled Black (RR = 2.05, 95% CI: 1.99, 2.11), nondisabled Hispanic (RR = 1.36, 95% CI: 1.34, 1.39), and disabled White birthing persons (RR = 2.44, 95% CI: 2.16, 2.77). For most other outcomes, risks were also largest for disabled Black birthing persons, followed by disabled Hispanic birthing persons. <b><i>Conclusions:</i></b> Black and Hispanic people with physical disabilities are highly likely to experience SMM and are at increased risk for other complications and adverse outcomes. Efforts are needed to understand underlying causes of these disparities and develop policies and practices to eliminate them.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854071","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":"A Whole-of-Government Approach to Addressing the U.S. Maternal Health Crisis.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1089/jwh.2024.0858","DOIUrl":"https://doi.org/10.1089/jwh.2024.0858","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807638","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}