Journal of women's health最新文献

{"title":"Severe Maternal Morbidity and Postpartum Care: An Investigation Among a Privately Insured Population in the United States, 2008-2019.","authors":"Jennifer L Matas, Laura E Mitchell, Jason L Salemi, Cici X Bauer, Cecilia Ganduglia Cazaban","doi":"10.1089/jwh.2024.0826","DOIUrl":"10.1089/jwh.2024.0826","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study examines postpartum health care utilization among women with severe maternal morbidity (SMM) subtypes (e.g., blood transfusion, renal), focusing on both early (within 7 days) and late (8-42 days) postpartum periods. By including outpatient visits alongside inpatient and emergency department (ED) visits, the study offers a comprehensive view of postpartum health care needs among women with SMM. <b><i>Methods:</i></b> This retrospective cohort study used data from Optum's de-identified Clinformatics® Data Mart Database from 2008 to 2019. The primary outcomes were early and late postpartum inpatient readmissions, early and late ED visits, and outpatient care within 42 days after delivery. Multilevel logistic regression models were used to estimate the association between SMM subtypes and postpartum readmission, ED, and outpatient care. <b><i>Results:</i></b> Except for hemorrhage, most SMM subtypes increased the postpartum odds of health care utilization. Women with other medical SMM (e.g., puerperal cerebrovascular disorders or sickle cell disease with crisis) had 2.9 times the odds (odds ratio [OR]: 2.87, 95% confidence interval [CI]: 1.30-6.34) of experiencing early readmissions compared with those without other medical SMM. Women with sepsis had 4.5-fold elevated odds (OR: 4.53, 95% CI: 2.48-8.28) of late readmission, a 1.9-fold increased odds (OR: 1.85, 95% CI: 1.12-3.04) of early ED visits, and over a 2-fold increased odds (OR: 2.27, 95% CI: 1.67-3.08) of postpartum outpatient visits compared with those without sepsis. <b><i>Conclusion:</i></b> This study reveals that certain SMM subtypes significantly increase postpartum health care utilization, emphasizing the need for further research and interventions to improve outcomes for affected women.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"539-548"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794955","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":"Preeclampsia Prevention: Key to the Reduction of Maternal Mortality.","authors":"Steven J Ralston, Eli Y Adashi","doi":"10.1089/jwh.2025.0141","DOIUrl":"https://doi.org/10.1089/jwh.2025.0141","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730590","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":"Congressional Efforts at Stemming the Maternal Mortality Tide: Not Quite Enough.","authors":"Eli Y Adashi, Daniel P O'Mahony, Glenn I Cohen","doi":"10.1089/jwh.2025.0130","DOIUrl":"https://doi.org/10.1089/jwh.2025.0130","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710306","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":"Challenges to Physician-Scientist Training Amid Restrictive Reproductive Health Policies.","authors":"Ammar D Siddiqi, Jasmine A Tuazon, Clayton D Rawson, Brad A Ryva, Elias M Wisdom, Rohini N Guin, Jessica L Ding","doi":"10.1089/jwh.2025.0117","DOIUrl":"https://doi.org/10.1089/jwh.2025.0117","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670243","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":"Combined Mammographic Breast Density and Breast Arterial Calcification as an Incremental Predictor of Coronary Artery Disease.","authors":"Emma Aldous, Vinay Goel, William Cameron, Chee Yeong, Nushrat Sultana, Rachael Hii, Huong Tu, Anthony Salib, Edwin Xu, Sarang Paleri, Sheran Vasanthakumar, Rhea Nandurkar, Andrew Lin, Nitesh Nerlekar","doi":"10.1089/jwh.2024.0966","DOIUrl":"https://doi.org/10.1089/jwh.2024.0966","url":null,"abstract":"<p><p><b><i>Background:</i></b> Contemporary risk calculators underestimate coronary artery disease (CAD) risk in women. Breast arterial calcification (BAC) associates with CAD. Low breast density (BD) (greater breast adipose tissue) associates with cardiometabolic disease. Both are readily identifiable on screening mammography. We sought to evaluate the association between the combined features of BD, BAC, and CAD. <b><i>Methods:</i></b> We retrospectively studied women with clinically indicated mammography and contemporaneous coronary computed tomography angiography. CAD risk was estimated by CAD Consortium Scoring (CCS;>15% high risk). BD was visually assessed by four-level Breast Imaging-Reporting and Data System (BI-RADS) (low:BI-RADS A-B, high:BI-RADS C-D). BAC was visually assessed as present/absent. CAD was categorized as presence/absence of coronary artery plaque. Results are presented with odds ratio (OR) and [95% confidence intervals], and area under the curve (AUC). <b><i>Results:</i></b> In 153 patients (age 62 ± 10), low BD (67%) and BAC presence (24%) were both associated with CAD, respectively: OR: 3.21 [1.58-6.60], <i>p</i> = 0.001, and OR: 4.36 [1.58-12.00], <i>p</i> = 0.004. CAD proportion in low BD (68.9%) and BAC (42.9%) was lower than with combined low BD+BAC positive (89.7%). Compared with (high BD+BAC negative), the presence of (low BD+BAC positive) associated with CAD independent of modifiable (OR: 9.12 [2.44-45.83], <i>p</i> = 0.002) and nonmodifiable (OR: 4.87 [1.22-25.02], <i>p</i> = 0.035) risk factors. CCS >15% was seen in 33%. Significant incremental value was seen with the addition of BD/BAC status to CCS (AUC 0.64 versus 0.73, <i>p</i> = 0.004). <b><i>Conclusions:</i></b> Mammographic BAC and low BD, both alone and combined, associate with CAD, and improve risk prediction beyond standard coronary risk estimation. Standardized reporting of these features may provide benefit and should be tested in prospective screening studies.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663763","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":"Diagnosis and Treatment of Gestational Diabetes Mellitus: A National Survey of Physician Practices.","authors":"Sarah E Miller, Meryl M Sperling, Jonathan A Mayo, Stephanie A Leonard, Deirdre J Lyell, Tiffany Herrero, Yair J Blumenfeld","doi":"10.1089/jwh.2024.0918","DOIUrl":"https://doi.org/10.1089/jwh.2024.0918","url":null,"abstract":"<p><p><b><i>Aims:</i></b> We aimed to identify changes in United States practice patterns in gestational diabetes mellitus (GDM) diagnosis and treatment following publication of the 2008 Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study that supported transition toward a 2-hour oral glucose tolerance test. <b><i>Methods:</i></b> A total of 1,030 U.S. obstetric providers were surveyed in 2021 about GDM screening, diagnosis, and treatment, as well as perceptions surrounding preparation for the 1-hour, 50-g glucose loading test (GLT). Data were compared with data from a similar 2003 survey. The study was reviewed by the Institutional Review Board at Stanford University and was determined to be exempt. <b><i>Results:</i></b> Of 1,030 providers surveyed, 304 (30%) responded. Most respondents continued using the two-step screening method (95.0% versus 95.2% in 2003, <i>p</i> = 0.18). Fewer providers used insulin as a first-line medication (64.1% in 2021 versus 82.3% in 2003, <i>p</i> < 0.001). However, providers practicing for 0-10 years often used insulin as first-line compared with providers practicing for over 10 years (79% versus 55%, <i>p</i> < 0.001). Of 2021 respondents, 39.3% believed that fasting before the 1-hour GLT lowers the glucose result, 34.3% believed it increases the result, and 26.4% believed it would have no effect. <b><i>Conclusions:</i></b> Despite data from the HAPO trial, the majority of providers surveyed still use the two-step method for GDM screening. There is wide variability in perceptions and counseling regarding preparation for the 1-hour GLT.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605454","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":"Examining Family Violence and Reproductive Autonomy Among Arab American Women.","authors":"Angubeen G Khan, Jennifer Cruz, Mona Makki, Madiha Tariq, Yasamin Kusunoki","doi":"10.1089/jwh.2024.0630","DOIUrl":"https://doi.org/10.1089/jwh.2024.0630","url":null,"abstract":"<p><p><b><i>Background:</i></b> Women who experience violence from an intimate partner are at risk of experiencing lower levels of reproductive autonomy. Among Arab American women, cases of intimate partner violence may also involve other family members, including in-laws or natal family, a phenomenon also known as family violence. This study examined the role of family violence on reproductive autonomy among Arab American women. <b><i>Methods:</i></b> Data were collected from a convenience sample (<i>N</i> = 99) of self-identified Arab American women between 18 and 65 years in Dearborn, Michigan, through a cross-sectional survey of self-reported experiences with family violence and reproductive autonomy. Analyses included univariate statistics on sociodemographic characteristics and prevalence of family violence, a psychometric analysis of a multidimensional scale of reproductive autonomy, and adjusted linear regressions to assess how sociodemographic characteristics and family violence were associated with reproductive autonomy. <b><i>Results:</i></b> Nearly 60% of the sample had ever experienced family violence. Among women who had ever had sex (<i>N</i> = 74), higher educational attainment was positively associated with communication and freedom from coercion, and receipt of public assistance was negatively associated with communication. Several types of family violence were negatively associated with the communication and freedom from coercion subscales from the reproductive autonomy measure. <b><i>Conclusion:</i></b> This study demonstrated that sociodemographic factors and family violence are both associated with reproductive autonomy among Arab American women. More research is needed to address family violence and reproductive autonomy in this community and examine how these experiences shape the reproductive health of Arab American women.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557137","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":"Long-Acting Reversible Contraception Use after Non-Receipt of Postpartum Permanent Contraception: A Retrospective Analysis.","authors":"Jill M Hagey, Ambika V Viswanathan, Brooke W Bullington, Kristen A Berg, Emily S Miller, Margaret Boozer, Tania B Serna, Jennifer L Bailit, Kavita S Arora","doi":"10.1089/jwh.2024.0395","DOIUrl":"10.1089/jwh.2024.0395","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate long-acting reversible contraception (LARC) use versus permanent contraception (PC) use at hospital discharge through 1 year postpartum after an unfulfilled immediate postpartum PC request. <b><i>Study Design:</i></b> We present a secondary analysis of a retrospective cohort study of patients across four study sites between 2018 and 2019 with PC as their documented inpatient postpartum contraceptive plan. We abstracted demographic and clinical characteristics, contraceptive plans and time to contraceptive fulfillment, reasons for non-fulfillment, and pregnancy incidence up to 1 year postpartum from medical records. <b><i>Results:</i></b> Of 3,013 patients initially desiring PC, 1,759 patients (58.4%) received PC and 136 patients (4.5%) received LARC on discharge; with an additional 217 patients receiving PC and an additional 176 patients receiving LARC in the 1 year postpartum. Participants who received inpatient LARC were more likely to be younger, to be unmarried, to have Medicaid insurance, and to have delivered vaginally compared with participants who received inpatient PC. Of the 304 patients who received LARC rather than PC during the year postpartum, 49 (16.1%) expressed an interest in LARC prenatally. Reasons for non-fulfillment of PC were varied at different time points postpartum, with 50.3% stating they did not receive PC by 1 year postpartum because they had changed their mind. <b><i>Conclusions:</i></b> Ten percent of patients with an unmet postpartum PC request use LARC methods instead at 1 year postpartum. Patients who do use LARC are unlikely to bridge to receipt of PC. Institutions should prioritize fulfillment of desired postpartum PC prior to hospital discharge.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"307-313"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468910","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":"\"No One Really Prepares You\": Lived Experiences of Women Division Chiefs in Academic Medicine.","authors":"Jaspreet Loyal, Rebecca Beagan, Magna Dias, Andrea Asnes","doi":"10.1089/jwh.2024.0416","DOIUrl":"10.1089/jwh.2024.0416","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Although women have comprised at least 50% of medical school classes for decades, women remain underrepresented in leadership positions. Although the proportion of women division chiefs in the U.S. academic medical centers is small, it is growing. Division chief positions can be a precursor to more senior level leadership positions. Our objective was to explore the lived experience of women division chiefs across specialties. <b><i>Materials and Methods:</i></b> We conducted a qualitative study using semi-structured interviews of women division chiefs from medical and surgical subspecialties in 2023 at a major academic medical center in the northeastern United States. We used the grounded theory approach and the constant comparative method until thematic sufficiency was reached. <b><i>Results:</i></b> We interviewed 18 of a total of 29 women division chiefs (62%). The following major themes emerged: (1) Most women are externally motivated to seek out the division chief role, (2) formal preparation or leadership development prior to taking on the section chief role is lacking, (3) leaders (both men and women) who sponsor and mentor women facilitate their success, and (4) women leaders face specific challenges including promotion delays and lack of recognition of their authentic leadership styles. We found the following minor themes: (1) Lack of formal onboarding to the division chief role; (b) positive influence of women in senior leadership roles within the institution; and (c) barriers to leadership roles include feeling undervalued in preceding leadership roles, navigating parenthood, and need for broader sponsorship. <b><i>Conclusion:</i></b> Opportunities to support the continued growth of women division heads include more deliberate recruitment and succession planning; a structured, formal onboarding process; acceptance of authentic leadership styles; and more practical ways to support parenting.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"e401-e408"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882530","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":"Perceptions of Lactation Experience Among Neurology Faculty and Impact of Lactation Time on Academic Achievement at U.S. Academic Medical Centers.","authors":"Sarah R Durica, Jesse Miller, Cynthia Zheng, Parneet Grewal, Chen Zhao, Halley B Alexander, Suma Shah, Sarah Isis R Delima, Annie He, Ailing Yang, Christa O'hana S Nobleza, Padmaja Sudhakar, Kamala Rodrigues, Myriam Abennadher, Doris H Kung, Neishay Ayub, Natasha Frost, Seema Nagpal, Katherine Zarroli, Sol De Jesus, Nicole Brescia, Nancy Foldvary-Schaefer, Laura Tormoehlen, June Yoshii-Contreras, Deborah Bradshaw, Jane B Allendorfer, Alyssa F Westring, Julie K Silver, Sasha Alick-Lindstrom, Sima I Patel","doi":"10.1089/jwh.2024.0363","DOIUrl":"10.1089/jwh.2024.0363","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To investigate the perceptions of lactation experiences of neurology faculty and the impact of lactation time on academic achievement. <b><i>Materials and Methods:</i></b> This was a cross-sectional study utilizing a survey administered across 19 academic neurology centers in the United States. Respondents self-identified as having children and answered questions about lactation at work. Demographic information; academic achievement including publications, guest speakerships, awards, leadership roles, and funding; and perception of lactation experience were analyzed. <b><i>Results:</i></b> Among 162 respondents, 83% took lactation time at work. Thirty-seven percent reported lack of employer support for lactation, 46% were dissatisfied with their lactation experience, 59% did not receive compensation for lactation time, 62% did not have blocked clinical time, 73% reported relative value units were not adjusted to accommodate lactation, and 43% reported lack of access to private lactation space. Women spent on average 9.5 months lactating per child and desired 2.4 further months of lactation. There was no difference in all measures of self-reported academic achievement between women who did and did not take lactation time when measured across all career stages. <b><i>Conclusions:</i></b> Although a majority of respondents took lactation time at work, perceptions of employer support for lactation were low, and expectations for work productivity were not adjusted to accommodate lactation time. Taking lactation time at work did not decrease self-reported academic achievement. System-level best practices designed to support lactating faculty should be developed to guide academic institutions.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"e416-e425"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503021","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}