Journal of women's health最新文献

{"title":"Trends in Pregnancy Outcomes in People with Sickle Cell Disease and Medicaid Insurance (2006-2018).","authors":"Sarah H O'Brien, Joseph R Stanek, Andrea House, Robert M Cronin, Susan E Creary, Andrea H Roe, Sara K Vesely","doi":"10.1089/jwh.2023.1109","DOIUrl":"10.1089/jwh.2023.1109","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although the risk of pregnancy-related morbidity and mortality in people with sickle cell disease (SCD) is well established, limitations in data sources and heterogeneity in outcome reporting hinder the ability to make meaningful comparisons between historical and contemporary populations. This study used a national administrative claims database to compare pregnancy outcomes in people with SCD between 2006-2011 and 2012-2018. <b><i>Materials and Methods:</i></b> Pregnant females aged 16-44 years with SCD were identified from the Centers for Medicare and Medicaid Service Analytic eXtract, along with a control cohort of pregnant people. People were followed from first identified pregnancy until one year postpartum. Outcomes of interest were identified with ICD-9 or 10 codes. <b><i>Results:</i></b> We included 6,388 people with SCD and 17,278 controls in analyses. Preeclampsia/eclampsia, hypertension, thrombosis, poor fetal growth, preterm delivery, and postpartum hemorrhage were all more common in people with SCD compared with controls. Maternal death occurred in 0.5% of people with SCD versus <0.1% in those without SCD (<i>p</i> < 0.001). When comparing infant deliveries in 2006-2011 to those occurring in 2012-2018, all pregnancy-related complications except preterm delivery, including maternal death, occurred at similar or higher frequencies in more recent years. <b><i>Conclusions:</i></b> Between 2006 and 2018, maternal death occurred in approximately 1 out of every 200 publicly insured people with SCD in the year following infant delivery. Our work confirms, on a national-level, that pregnancy-related outcomes in people with SCD in the United States have not improved with time, and that some complications have in fact increased in frequency.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"21-26"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546235","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":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/jwh.2024.01254.revack","DOIUrl":"https://doi.org/10.1089/jwh.2024.01254.revack","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":"34 1","pages":"159-161"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950770","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":"Patient-Reported Pregnancy Outcomes and Survival in Women with Aortic Valve and/or Aortic Root Replacement.","authors":"Rachel G Sinkey, Kathryn S Maxwell, Luz A Padilla, Isabel C Collins, Vanessa M Miller, Macie L Champion, Jeff M Szychowski, Dave Mauchley, Marc G Cribbs, Martha S Wingate, Brian M Casey, Alan T N Tita","doi":"10.1089/jwh.2023.0923","DOIUrl":"10.1089/jwh.2023.0923","url":null,"abstract":"<p><p><b><i>Background:</i></b> Our objective was to investigate patient-reported maternal and perinatal outcomes and survival among women undergoing aortic valve and/or aortic root replacement (AVR/ARR). <b><i>Methods:</i></b> This was a single-center observational study of U.S. women identified in our surgical/obstetric databases who underwent AVR/ARR between 1967 and 2019. Available, consenting patients participated in a telephone survey detailing patient-reported outcomes. The status of remaining individuals was verified through the Alabama Department of Public Health. Date of death, immediate and underlying cause of death, and death location were abstracted from death certificates. <b><i>Results:</i></b> Of 317 patients, 72 were confirmed living, 86 were deceased, and 159 were of unknown status. Mean age at first aortic valve replacement was 43 years. Of patients with known status (<i>n</i> = 158), 33% were Black, and the majority received a mechanical valve (58%). Of 57 participants completing the survey, reported complications included miscarriage (30%), preterm birth (12%), preeclampsia (14%), antepartum maternal intensive care unit admissions (6%), and congenital heart disease in the neonate (8%). Most pregnancies preceded AVR (78%). Among 86 decedents, the average age of death was 52.5 years; the average time from AVR/ARR to death was 7 years. Of those who died, a higher proportion were Black (75%) and had aortic insufficiency (72%). <b><i>Conclusions:</i></b> Patients who underwent aortic valve surgery report high rates of maternal and perinatal complications, and death certificate data confirm high rates of racial disparities and death within a decade of surgery. Interventions are urgently needed to improve maternal and perinatal outcomes in individuals with aortic valve disease and to eliminate preventable racial disparities.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"95-102"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710272","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":"Abortion After Pregnancy Occurrence with Contraceptive Use Among Veterans.","authors":"Carly O'Connor-Terry, Xinhua Zhao, Maria K Mor, Judy C Chang, Lisa S Callegari, Sonya Borrero, Deirdre A Quinn","doi":"10.1089/jwh.2023.0829","DOIUrl":"10.1089/jwh.2023.0829","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Many people report becoming pregnant while using contraception. Understanding more about this phenomenon may provide insight into pregnant people's responses to and healthcare needs for these pregnancies. This study explores the outcome (e.g., birth, miscarriage, abortion) of pregnancies among Veterans in which conception occurred in the month of contraceptive use. <b><i>Study Design:</i></b> We used data from the <i>Examining Contraceptive Use and Unmet Need Study,</i> a telephone-based survey conducted in 2014-2016 of women Veterans (<i>n</i> = 2302) ages 18-44 receiving primary care from the Veterans Health Administration. For each pregnancy, we estimated the relationship between occurrence in the month of contraceptive use and the outcome of the pregnancy using multinomial logistic regression, controlling for relevant demographic, clinical, and military factors and clustering of pregnancies from the same Veteran. <b><i>Results:</i></b> The study included 4436 pregnancies from 1689 Veterans. Most participants were ≥30 years of age (<i>n</i> = 1445, 85.6%), identified as non-Hispanic white (<i>n</i> = 824, 51.6%), and lived in the Southern United States (<i>n</i> = 994, 55.6%). Nearly 60% (<i>n</i> = 1007) of Veterans who had ever been pregnant reported experiencing a pregnancy in the month of contraceptive use; a majority of those pregnancies (<i>n</i> = 1354, 80.9%) were described as unintended. In adjusted models, pregnancies occurring in the month of contraceptive use were significantly more likely to end in abortion (aOR: 1.76, 95% CI: 1.42-2.18) than live birth. <b><i>Conclusions:</i></b> Pregnancy while using contraception is common among Veterans; these pregnancies are more likely to end in abortion than live birth. Given widespread restrictions to reproductive health services across much of the United States, ensuring Veterans' access to comprehensive care, including abortion, is critical to supporting reproductive autonomy and whole health.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"103-110"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469103","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":"Female Victims of Firearm Intimate Partner Violence: Characterization and Lethality Predictors.","authors":"Lauren T Callaghan, Gracen Moran, Deborah Brisola, Kyle Blackburn, Belia Camarena, Ojas Dumbre, Cary Cain, Caitlin Perez-Stable, Tiffany Lee, Catherine Seger, Bindi Naik-Mathuria","doi":"10.1089/jwh.2024.0279","DOIUrl":"10.1089/jwh.2024.0279","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To characterize the sociological risk factors for firearm intimate partner violence (IPV) among women in Texas, with a focus on lethal predictors to aid in screening and intervention guidelines. <b><i>Methods:</i></b> A retrospective medical and forensic chart review was conducted and supplemented by news sources, public police reports, and court records on firearm cases in Houston, TX, from 2018 to 2020. IPV was defined as a cis-gendered female victim of firearm violence from a current or ex-intimate partner. Non-IPV was defined as cis-gendered female victims of firearm violence from strangers, friends/acquaintances, gang, client, or similar relationships. Numeric variables were compared using the Wilcoxon rank-sum test and reported as median [Q1, Q3]. Categorical variables were compared using Fisher's exact test and reported as count (%). <b><i>Results:</i></b> A total of 102 cases of IPV were identified. Nonspousal IPV was more prevalent than spousal (65.7% versus 34.3%). Lethal injuries, older age, home location, and head injuries were more prevalent in the IPV cohort. Older age, spousal perpetrator, home shooting location, and history of prior domestic abuse were associated with lethal IPV. There were 31 cases of murder-suicide. During the COVID-19 pandemic, IPV cases increased by 91.3%, with lethal cases increasing by 57.6%. <b><i>Conclusion:</i></b> Risk factors for overall IPV and lethal IPV are not the same; therefore, it is imperative that all women, irrespective of race, age, or relationship status, be screened for IPV and prior domestic violence to allow intervention and prevention of lethal IPV. Patients should also be screened for personal or partner access to firearms as firearm IPV is a highly lethal form of violence.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"111-117"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126095","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":"Predictors of Human Papillomavirus Vaccination in the Postpartum Period for Individuals Aged 18-26.","authors":"Christine G T Nguyen, Ava Mandelbaum, Lucy Ward, Katherine Bolten, Keenan Yanit, Jessica Currier, Amanda S Bruegl","doi":"10.1089/jwh.2024.0551","DOIUrl":"10.1089/jwh.2024.0551","url":null,"abstract":"<p><p><b><i>Background:</i></b> Human papillomavirus (HPV) vaccination during the postpartum period is an opportunity for vaccine eligible individuals to be vaccinated. <b><i>Objective:</i></b> Identify predictors of vaccine acceptance in the postpartum period among patients aged 18-26. <b><i>Study Design:</i></b> A retrospective chart review was conducted to evaluate the rate of HPV vaccination to eligible postpartum patients aged 18-26 who delivered between January 2021 and May 2023 at our institution. Clinical and demographic data were extracted. Comparisons were made between fully vaccinated individuals and those who were unvaccinated or incompletely vaccinated. Variables significantly associated with vaccination status or acceptance were included in a multivariable logistic regression model. <b><i>Results:</i></b> Of the 1,130 patients who met the study inclusion criteria, 42.1% were eligible for postpartum HPV vaccination. The average age was 23 years, the majority White (74.5%), and English speaking (93.1%). Nineteen percent of eligible patients accepted HPV vaccination, with differences between those who accepted or declined the vaccine identified in: preferred language, tobacco use, delivering provider's specialty, and receiving any vaccination during pregnancy. Spanish-speaking patients had >5× the odds of accepting the vaccine compared with English-speaking patients. Smokers, patients delivered by a family medicine provider, and those who accepted any vaccine during pregnancy had more than twice the odds of receiving the vaccine postpartum. <b><i>Conclusion(s):</i></b> The postpartum period remains an opportunity to provide HPV vaccination. Our study identified patients less likely to be vaccinated prior to delivery, as well as patients who are more likely to accept vaccinations postpartum.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"36-50"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140465","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":"Reproductive Experiences of Physicians in Medical and Surgical Subspecialties.","authors":"Jensen D Reckhow, Alessandra J Ainsworth, Kimberly A Holst, Elizabeth B Habermann, Ruth E DeFoster Bates, Susan N Kok, Chandra C Shenoy","doi":"10.1089/jwh.2023.0579","DOIUrl":"10.1089/jwh.2023.0579","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate the reproductive experiences of physicians across gender and specialty. <b><i>Patients and Methods:</i></b> Between November and December 2021, we surveyed nontrainee physicians of all genders at a single quaternary institution using a modified version of an existing survey instrument. Experiences with family planning, fertility, pregnancy, and parental leave were assessed. <b><i>Results:</i></b> There were 422 completed responses. Respondents reported a higher prevalence of infertility as compared to the general U.S. population (26% versus 19%), with no difference in infertility or obstetrical complications by specialty. Most respondents (75%) reported stigma regarding having children in medicine, and 71% reported delaying childbearing. These trends were strongest in the subanalysis of female respondents. Forty-five percent of respondents reported that their work increased the risk for subfertility, infertility, or pregnancy complications. Surgeons were significantly more likely to report physically demanding work conditions (75% versus 30%, <i>p</i> < 0.001), radiation exposure (39% versus 14%, <i>p</i> < 0.001), and bloodborne pathogen exposure (25% versus 12%, <i>p</i> = 0.03) as occupational reproductive hazards. Only 55% of respondents with a pregnancy history reported ever taking parental leave. Among those who took less than the full amount offered, 63% cited concerns about falling behind educationally or professionally as significantly influencing this decision. <b><i>Conclusions:</i></b> These results support previous trends showing delayed childbearing and increased infertility among physicians while shedding new light on stigma associated with childbearing and parental leave. A better understanding of the reproductive experiences of physicians is critical to recruiting and retaining a skilled workforce and fostering career and life satisfaction in this profession.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"133-142"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468914","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":"From Healing to Hurting: Addressing Sex- and Gender-Based Differences in Chronic Postsurgical Pain.","authors":"Lopa Misra, Suneela Vegunta, Tarrah A Folley","doi":"10.1089/jwh.2024.0701","DOIUrl":"10.1089/jwh.2024.0701","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"156-158"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290205","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":"Hand Osteoarthritis and Subclinical Cardiovascular Disease in Middle-Aged Women.","authors":"Rodrigo Rafael Flores-Marinelarena, Tatiana Sofia Rodríguez-Reyna, Carlos Cantú-Brito, Martín Lajous, Mario H Flores-Torres, Valeria Valaguez-Moreno, Carlos Eduardo Herrera-Venegas, Andres Catzin-Kuhlmann","doi":"10.1089/jwh.2023.1088","DOIUrl":"10.1089/jwh.2023.1088","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To determine subclinical cardiovascular disease (sCVD) in middle-aged women with clinically manifested hand osteoarthritis (HOA) and to improve the characterization of cardiovascular risk in this population. <b><i>Design:</i></b> We cross-sectionally evaluated the relationship between HOA and sCVD in 1,803 volunteers from the Mexican Teachers' Cohort. From 2012 to 2016, a subsample from Mexico City, the Northern state Nuevo León, and the Southern states Chiapas and Yucatán was invited for clinical evaluations, during which neurologists examined carotid arteries using ultrasound, and a standardized HOA questionnaire was also administered. HOA was defined as age ≥45 years, hand joint pain, and morning stiffness that lasted no longer than 30 minutes. sCVD was assessed using the intima-media thickness (IMT) and atherosclerotic plaques. <b><i>Results:</i></b> Among participants with a mean age of 51 years (±4), 18.4% met the criteria for HOA, and the prevalence of carotid atherosclerosis was 23.1%. After multivariable adjustment, women diagnosed with HOA had a 1.8% (95% confidence interval [CI] 0.3, 3.3) greater mean IMT than those without this joint disease. Similarly, women with HOA had 36% (95% CI 1.01, 1.84) higher odds of carotid atherosclerosis. <b><i>Conclusions:</i></b> HOA is associated with sCVD in middle-aged women. This relationship might be due to low-grade chronic inflammation; however, further research is required to clarify the underlying mechanisms.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"78-84"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349210","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 Risk Conditions and Outcomes by Levels of Maternal Care.","authors":"Carla L DeSisto, Alexander C Ewing, Hafsatou Diop, Sarah Rae Easter, Elizabeth Harvey, Debra J Kane, Miriam Naiman-Sessions, Godwin Osei-Poku, Melanie Riley, Birgit Shanholtzer, Audrey M Stach, Ramya Dronamraju, Andrea Catalano, Elizabeth A Clark, Sabrina A Madni, Lindsay S Womack, Elena V Kuklina, David A Goodman, Sarah J Kilpatrick, M Kathryn Menard","doi":"10.1089/jwh.2024.0547","DOIUrl":"10.1089/jwh.2024.0547","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC). <b><i>Methods:</i></b> We used the 2017-2019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC. <b><i>Results:</i></b> We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III/IV compared with <Level III facilities. Among patients with cardiac conditions, the magnitudes of the associations with these outcomes, along with stroke, were also lower in Level III/IV compared with <Level III facilities. The proportion of patients with risk conditions that delivered in <Level III facilities was 19.8-46.8%. <b><i>Conclusions:</i></b> Odds of severe adverse outcomes among women with selected risk conditions were lower for births occurring at higher-level facilities, supporting the benefit of risk-appropriate care.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"51-59"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503020","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}